Diagnosing Brachial Plexus

The brachial plexus is a group of nerves that come from the spinal cord and control the movement in the arms, the shoulders, and hands. Injuries or traumatic happenings to this network may render the arm useless. This could be due to accidents, at birth due to trauma (called Erb’s palsy or obstetrical brachial plexus), a tumor, compression or irradiation may cause the arm to fail in its function. There may be tingling, numbness, weakness, muscle failure, paralysis or pain in the hand. This type of injury may affect one child in two thousand births.

The site and type of brachial plexus determine the prognosis. There are four types of injuries- avulsion and rupture are serious ones which may need surgical intervention. The potential for recovery from neuroma and neuropraxia injuries varies. Most patients with neuropraxia injuries recover fast, some within three or four months without surgery and the success rate and return of normal functions for these injuries is ninety to hundred percent.

Symptoms of brachial plexus injuries are noticed immediately after the injury or the birth but action may be delayed, as other injuries may need more urgently. However the evaluation should be done soon so that further detriment will not take place. Each case of brachial plexus injury is different, will be diagnosed separately and treated differently. The type and length of treatment, chances of recovery vary from patient to patient. Though most such injuries heal without much intervention, there may be cases where lifelong therapy and treatment may be needed. Some may need to be monitored for long periods.

The initial examination and diagnosis consists of physical examination and thorough study of the patient’s medical history and x rays. Myelogram is a test in which a dye is injected into the spinal fluid and one can trace the extent of the injury from the color when it spreads, and subsequent x rays. Electromyogram (EMG or electromyography) is a test which measures how quickly the nerves can carry electrical signals to the muscles. A thin electrode is inserted into the affected muscle by the nerve injury. An instrument records the electrical activity at rest and when the muscles contract.

Based on the findings of these tests and by the physical tests and appearance, the treatment is decided. If the first type of treatment does not give a good rate of success, further tests and treatment can also be made which will attempt to make the person as normal as possible.