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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 ...
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]
It is also known as brachial plexitis, and results in brachial plexus inflammation without any apparent shoulder injury. PTS can manifest with severe pain in the shoulder or arm, followed by numbness and weakness. [5] Parsonage–Turner syndrome occurs in about 1.6 out of 100,000 people every year. [6]
While chronic progressive brachial monoplegia is uncommon, syringomyelia and tumors of the cervical cord or brachial plexus may be the cause. The onset of brachial plexus paralysis is usually explosive where pain is the initial feature. Pain localizes to the shoulder but may be more diffuse, or could be limited to the lower arm.
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.
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.
The right brachial plexus, viewed from in front. Specialty: Vascular surgery, thoracic surgery: Symptoms: Pain, weakness, loss of muscle at the base of the thumb, swelling, paleness, bluish coloration [1] [2] Usual onset: 20 to 50 years of age [1] Types: Neurogenic, venous, arterial [1] Causes
When the triad of an ipsilateral Horner's syndrome, shoulder/arm pain and weakness of the intrinsic hand muscles occurs, the presentation is called the Pancoast syndrome. This syndrome is due to involvement of brachial plexus roots and that of sympathetic fibers as they exit the cord at T1 and ascend to the superior cervical ganglion. [11] [10]