Brachial plexus injuries

The brachial plexus is a network of nerves that carries signals from the upper parts of the spinal cord to your shoulder, arm, and hand. These nerves involve movement and sensation and allow you to raise your arm and move your hand and wrists. Brachial plexus injuries (also known as Erb's palsy and Dejerine-Klumpke palsy) are caused by damage to those nerves, typically from trauma, tumors, inflammation, pressure, athletic injuries, or being stretched too far. Some brachial plexus injuries can happen to babies during birth.

Erb's palsy refers to numbness and paralysis of the upper brachial plexus. Dejerine-Klumpe palsy (also known as Klumpke's palsy) refers to loss of sensation in the wrist and hand and paralysis of the lower brachial plexus. A rare syndrome called Parsonage-Turner Syndrome, or brachial plexitis, causes inflammation of the brachial plexus without any obvious shoulder injury. 

Symptoms of a brachial plexus injury may include:

• A limp or paralyzed arm
• Lack of muscle control in the arm, hand, or wrist
• A lack of feeling or sensation in the arm or hand
• Sudden pain in the shoulder or arm that may be stinging or burning

Although injuries can occur at any time, many brachial plexus injuries happen when a baby's shoulders become impacted during delivery and the brachial plexus nerves stretch or tear.

Types of brachial plexus injuries are:

• Neuropraxia or stretch, the mildest form in which the nerve has been damaged but not torn and causes some problems with nerve signaling
• Neuroma, in which the nerve has torn and healed but scar tissue puts pressure on the injured nerve and prevents it from conducting signals to the muscles
• Rupture, in which the nerve is torn but not at the spinal attachment
• Avulsion, the most severe type, in which the nerve is cut or torn from the spinal cord. There is also an incomplete form of avulsion in which part of the nerve is damaged and which leaves some opportunity for the nerve to slowly recover function

The severity of a brachial plexus injury depends on the nerves affected and the extent of the injury. Some injuries may be temporary, while others are chronic. Some brachial plexus injuries may heal without treatment. Some children who are injured during birth improve or recover on their own by 3 to 4 months of age. Most children recover some function through physical and occupational therapy.

In some cases (such as avulsion and rupture injuries), surgery is needed. Medications can help with pain management and assistive devices, such as splints or braces, may be needed by some individuals.

How can I or my loved one help improve care for people with a brachial plexus injury?

Consider participating in a clinical trial so clinicians and scientists can learn more about brachial plexus injury. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with brachial plexus injury at Clinicaltrials.gov, a database of current and past clinical studies and research results.

Where can I find more information about a brachial plexus injury?

Additional information is available from the following resources:

Genetics and Rare Diseases (GARD) Information Center

MedlinePlus

United Brachial Plexus Network
Phone: 781-315-6161

Content source: https://www.ninds.nih.gov/health-information/disorders/brachial-plexus-injury. Accessed July 11, 2023.

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