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A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5–C8), and first thoracic (T1) spinal nerves, and innervate the ...
Erb's palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the severing of the upper trunk C5–C6 nerves. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5–C8 and thoracic nerve T1.
Lower brachial plexus injuries should be distinguished from upper brachial plexus injuries, which can also result from birth trauma but give a different syndrome of weakness known as Erb's palsy. Other trauma, such as motorcycle accidents, that have similar spinal cord injuries to C8 and T1, also show the same symptoms of Klumpke's paralysis.
Brachial plexopathy is often caused from local trauma to the brachial plexus, as can happen from a dislocated shoulder. The disorder can also be secondary to compression or stretching of the brachial plexus (for example, during a baby's transit through the birth canal, in which case it may be referred to as Erb's Palsy or Klumpke's palsy). [2]
Injury to Erb's point is commonly sustained at birth or from a fall onto the shoulder.The nerve roots normally involved are C5 and partly C6. Symptoms include paralysis of the biceps, brachialis, and coracobrachialis (through the musculocutaneous nerve); the brachioradialis (through the radial nerve); and the deltoid (through the axillary nerve).
A variety of methods may be used to diagnose axillary nerve palsy. The health practitioner may examine the shoulder for muscle atrophy of the deltoid muscle. [2] Furthermore, a patient can also be tested for weakness when asked to raise the arm. [2] The deltoid extension lag sign test is one way to evaluate the severity of the muscle weakness.
Brachial plexus injuries can cause paralysis in various regions in the arm, forearm, and hand depending on the severed nerves. The resulting palsy has been clinically treated using the phrenic nerve as a donor for neurotization of the musculocutaneous nerve and the median nerve. [ 12 ]
[3] [1] Signs include retraction of the baby's head back into the vagina, known as "turtle sign". [1] Complications for the baby may include brachial plexus injury, or clavicle fracture. [2] [1] Complications for the mother may include vaginal or perineal tears, postpartum bleeding, or uterine rupture. [3] [1]