The brachial plexus is a group of nerves that run from the lower neck through the upper shoulder area. These nerves provide the shoulder, arm, forearm, and hand with movement and sensation.

Damage to the brachial plexus nerves, called brachial plexopathy, can cause muscle and sensation problems that are often associated with pain in the same area.

Adult brachial plexus injuries are often the result of high impact trauma such as a motorcycle injury, motor vehicle accident or sporting injury. Tumors, compression or irradiation therapy can also damage the brachial plexus.

Most pediatric (obstetric) brachial plexus injuries happen during birth.

Brachial Plexopathy Symptoms

Common symptoms include:

  • Loss of feeling or sensation in your arm or hand
  • Trouble moving your arm
  • Lack of muscle control in the arm, hand, or wrist

Brachial Plexopathy Diagnosis

Patients with brachial plexus injuries are affected in different ways. Brachial plexus injuries are usually discovered at birth or shortly after injury by an inequality of upper arm movement or suspicion because of the type of delivery or trauma.

The initial evaluation should occur as early as possible following injury. When evaluation is delayed beyond 6 to 9 months, treatment options are limited, although they could still be valuable in maximizing the recovery. The diagnosis is based on a thorough medical history and physical examination.

Studies including X-ray, MRI, CT, and EMG will also be utilized to assist the physician to locate the injury and to identify the severity of the nerve damage.

Brachial Plexopathy Treatment

The treatment for each child or adult is highly individualized based on the age, the type and severity of the injury. Immediately after injury, therapy and exercises should be emphasized to keep the muscles and joints flexible.

Surgery may be necessary if a patient has not recovered within several months. The purpose of surgery is to improve the arm function. Nerve surgery, if required, is most effective when it is done early and should ideally occur within 6 months and typically not later than one year after your injury.

By using microsurgical techniques, surgeons can repair the individual nerves of the brachial plexus to improve nerve regeneration and to restore some hand and arm functions. Treatments include:

  • Neurolysis: A minimally invasive procedure to release an entangled nerve from scar tissue.
  • Nerve graft: A procedure where portions of healthy nerve taken from another part of the patient's body are used to connect damaged or severed nerves with the hope to restore function.
  • Nerve transfer (neurotization): A surgery to suture an adjacent, functioning nerve into an irreparably injured nerve in an attempt to restore function in a paralyzed muscle.
  • Tendon transfer: A procedure to restore function to muscle by moving the anchor point of the muscle's tendon to another part of the bone.

Brachial Plexus and Peripheral Nerve Center

The Wake Forest Baptist Brachial Plexus and Peripheral Nerve Center provides a state-of-the-art diagnostic facility, surgical techniques and therapeutic approaches for patients with all types of obstetric and adult brachial plexus injuries and peripheral nerve pathologies. Our experienced, multi-specialty team includes reconstructive hand surgeons, neurologists, neurophysiologists, neuroradiologists, physical and occupational therapists.