Brachial plexopathy Health Article

Definition

Brachial plexopathy is pain, decreased movement, or decreased sensation in the arm and shoulder due to a nerve problem.

Alternative Names

Neuropathy - brachial plexus; Brachial plexus dysfunction; Parsonage Turner syndrome

Causes, incidence, and risk factors

Brachial plexus dysfunction (brachial plexopathy) is a form of peripheral neuropathy. It occurs when there is damage to the brachial plexus, an area where a nerve bundle from the spinal cord splits into the individual arm nerves.

Damage to the brachial plexus is usually related to direct injury to the nerve, stretching injuries, pressure from tumors in the area, or damage that results from radiation therapy.

Brachial plexus dysfunction may also be associated with:

• Birth defects that put pressure on the neck area
• Exposure to toxins, chemicals, or drugs
• Inflammatory conditions, such as those due to a virus or immune system problem

In some cases, no cause can be identified.

Symptoms

• Horner syndrome - possibly caused by a lung tumor that presses on the nerve
• Numbness of the shoulder, arm, or hand
• Shoulder pain
• Tingling, burning, pain, or abnormal sensations (location depends on the area injured)
• Weakness of the arm, hand, or wrist
  • Inability to extend or lift the wrist
  • Hand weakness

Signs and tests

Age and gender are important because some plexus problems are more common in certain groups (for example, young men more often have inflammatory brachial plexus disease).

A neuromuscular examination of the arm, hand, and wrist will show a problem with the nerves of the brachial plexus. Arm reflexes may be abnormal. Specific muscle problems may indicate which portion of the brachial plexus has been damaged.

Deformities may develop in the arm or hand, and there may be profound loss of muscle mass (atrophy).

Tests that reveal brachial plexopathy may include:

• Nerve conduction test and electromyography
• Nerve biopsy
• Special MRI views of the brachial plexus