The Brachial Plexus is a network of nerves that conducts signals from the spine to the shoulder, arm and hand.
Damage to these nerves can lead to paralysis of the arm, a lack of muscle control or a lack of sensation in the arm and hand.
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There are three types of brachial plexus birth injuries: Avulsion, Rupture and Neuropraxia
Description
The Brachial Plexus is a network of nerves that conducts signals from the spine
to the shoulder, arm and hand. Damage to these nerves can lead to paralysis of
the arm, a lack of muscle control or a lack of sensation in the arm and hand.
Cause
Brachial plexus injuries are caused by damage to the Brachial Plexus nerves. There
are three types of brachial plexus birth injuries:
Avulsion, the most severe type, in which the nerve is torn from the spine
Rupture, in which the nerve is torn but not at the spinal attachment, but
further down in the shoulder
Neuropraxia or stretch, in which the nerve has been damaged but not torn.
Neuropraxia is the most common type of brachial plexus birth injury.
Symptoms
Symptoms may include a limp or paralysed arm, lack of muscle control in the arm,
hand, or wrist, and lack of feeling or sensation in the arm or hand. Although
injuries can occur at any time, many brachial plexus injuries happen during birth,
when the baby's shoulders may become impacted during the birth process causing
the brachial plexus nerves to stretch or tear.
Treatment
Some brachial plexus injuries may heal naturally. Many children improve or recover
by three to four months of age. Treatment for brachial plexus injuries includes
physiotherapy and in the case of avulsions and ruptures, surgery may be embarked
on.
Prognosis
The site and type of brachial plexus injury determine the prognosis. For avulsion
and rupture injuries there is no potential for recovery unless surgical reconnection
is made in a timely manner. Most patients with neuropraxia injuries recover spontaneously
with a 90-100% return of function.
(Reviewed by Dr Andrew Rose-Innes, Yale University School of Medicine)
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