What is it?

Brachial plexus is a complicated network of nerves , which begins in the neck section of the spinal cord. Individual nerve fibres coming out of the neck section interweave in order to create a number of the most important nerves innervating the entire upper limb: the median nerve, the radial nerve and the ulnar nerve. The nerves responsible for movement are the motor nerves, for aesthesia are the sensory nerves.

Cause

Injury, prolonged compression, cutting, breaking, contusion may result in injury of brachial plexus nerves. Being very delicate structures, nerves may react even to small injuries by disturbance of transfer of information from the brain to the limb..

There are different types of brachial plexus nerve injuries:

• Contusion
• Stretching
• Rupture
• Disruption
• Avulsion

Depending on the mechanism of the injury, time of its duration, type of nerve lesion, extent of the lesion and the number of damaged nerves as well as the time of starting treatment, effects of treatment can be good or bad.

Symptoms

Extensiveness of the area of dysfunction of the limb depends mainly on the mechanism of the injury, time of its duration, type of nerve injury, extent of the injury and the number of injured nerves and the time of starting treatment. The dysfunction may include disturbances of the sensation of touch, temperature, weakness in the arm muscles force or cessation in performance of certain functions, e.g. flexion, extension or, in the case of the most serious injuries of the brachial plexus, total paralysis of an upper limb.

Examining and diagnosing the disease

A patient should be thoroughly examined. The appearance of a limb is assessed (muscular atrophy) and its functioning, strength, the sensation of touch, temperature, deficits (lack of flexion, extension). Additional examination is also performed: muscular and nerve conduction (NCS – nerve conduction study, EMG – electromyography), computer tomography CT, magnetic resonance imaging MRI.

Treatment

Depending on a number of factors: mechanism of an injury, degree of nerve damage, general state of health of a patient, and coexisting injuries, the treatment can be medical or surgical. The decision about which method of treatment to choose has to be taken by your GP. Despite of their excellent ability of spontaneous nerve regeneration not all nerve injuries subside without leaving deficits in their functioning. In spite of an implemented treatment, the extend of brachial plexus damage often fails to produce the expected good results.

Follow up

You are required to follow your surgeon’s recommendations and continue the ordered rehabilitation instructions.