Brachial Plexus Palsy: Causes, Symptoms, Treatment, Diagnosis

What Is Brachial Plexus Palsy?

Brachial Plexus Palsy is a pathological condition arising as a result of damage to the brachial plexus. The brachial plexus is a network of nerves which sends signals from the spinal cord to the upper extremities including the shoulder, arms, and hands.

The brachial plexus nerves control the functions of the arm. An individual with Brachial Plexus Palsy will not be able to move the muscles of the arm and will lose the ability to grip, grasp, or hold objects. There will also be lack of sensation on the affected extremity.

If the damaged nerves involve only the shoulder and elbow then it is termed as Erb’s palsy and if the entire hand is involved then it is termed as total plexus palsy.

What Is Brachial Plexus Palsy?

What Causes Brachial Plexus Palsy?

Brachial Plexus Palsy can be caused as a result of a high impact motor vehicle accident or a penetrating injury like a gunshot or a stab wound to the brachial plexus region. In high risk childbirth cases, if the shoulder of the baby gets caught in the birth canal then it may lead to a Brachial Plexus Palsy.

Certain tumors around the brachial plexus region may also result in a Brachial Plexus Palsy along with radiation treatments given to the chest area for certain forms of cancer.

What Are The Symptoms Of Brachial Plexus Palsy?

An individual with a Brachial Plexus Palsy will have weak or limp arm, wrist, and hand. The positioning of the hand will not be normal and will be turned inwards in cases of a Brachial Plexus Palsy. An individual with Brachial Plexus Palsy will have problems moving the arm, wrist, and hand. There will also be persistent pain in the hand as a result of Brachial Plexus Palsy. There will be loss of sensation and the individual will not be able to feel objects with the hand.

These symptoms are variable and can range from moderate to severe in intensity depending on the severity of the condition. The symptoms are maximized in cases where there is complete tear of the brachial plexus nerves from the spinal cord.

How Is Brachial Plexus Palsy Diagnosed?

In order to diagnose Brachial Plexus Palsy, a detailed examination of the affected hand will be done by the treating physician. The physician will also look for any lack of sensation or strength. A range of motion test of the hand will also be done to check whether motion of the hand is compromised.

If Brachial Plexus Palsy is suspected, then tests like EMG and nerve conduction study will be ordered to check the status of the muscles and see whether the nerves are functioning normally. The results of these tests will confirm the diagnosis of Brachial Plexus Palsy.

How Is Brachial Plexus Palsy Treated?

Brachial Plexus Palsy can be treated both conservatively as well as surgically. Conservative options are reserved for minor cases where the brachial plexus nerves get just stretched and are not detached from the spinal cord.

Conservative options include splinting and bracing along with physical therapy and occupational therapy to prevent stiffness and contractures of the hands due to lack of movement as a result of Brachial Plexus Palsy.

Surgery is reserved only for those patients with a serious case of Brachial Plexus Palsy. Surgery normally recommended for Brachial Plexus Palsy is a nerve transfer where healthy nerve from another place in the body is transferred to the brachial plexus to restore normal functioning of the hand.

Postsurgery, the patient will require aggressive physical therapy and occupational therapy to get the function back of the affected hand. The recovery from the surgery takes a significant amount of time as the nerves tend to heal extremely slowly. On an average, it will take around a year for an individual to completely recover from a Brachial Plexus Palsy.

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