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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.
Klumpke's paralysis is a variety of partial palsy of the lower roots of the brachial plexus. [1] [2] The brachial plexus is a network of spinal nerves that originates in the back of the neck, extends through the axilla (armpit), and gives rise to nerves to the upper limb.
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.
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).
Microsurgery can be used approaching the area from above the collar bone (supraclavicular) followed by neurolysis of the brachial plexus, removal of the scalene muscle (scalenectomy), and the release of the underlying (subclavicular) blood vessels. This approach avoids the use of resection, and has been found to be an effective treatment. [24]