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Brachial plexus palsy

Brachial plexus palsy

Brachial plexus palsy is a condition affecting the movement and sensation of the arm and hand. The brachial plexus is a group of nerves located between the neck and shoulders that control muscle function in the chest, arms, hands and shoulder. Brachial plexus palsy occurs when the arm, hand or shoulder is weakened or paralyzed due to an injury to the brachial plexus caused by compression or stretching of these nerves.

Brachial plexus palsy occurs during the childbirth process; the newborn’s nerves can be stretched, compressed or torn from the force exerted to pull them from the birth canal.

Injuries associated with brachial plexus palsy

Neurapraxia – This stretch injury shocks the nerve but does not tear it. This is the most common form of the condition and these injuries usually heal on their own within three months.

Neuroma – Neuroma is a stretch injury that damages nerve fibers, resulting in scar tissue. The scar tissue then presses on healthy nerves or interferes with nerve function.

Rupture – A rupture occurs when the nerve is torn.

Avulsion – An avulsion occurs when the nerve roots are torn from the spinal cord. This is the most serious type of injury.

Signs of brachial plexus palsy

The symptoms of brachial plexus palsy are:

  • Loss of feeling in one or both arms
  • Partial or total paralysis of the arm
  • Weakness in one or both arms

Diagnosing brachial plexus palsy

Your child’s doctor can diagnose brachial plexus palsy through a physical examination that can determine if there is any weakness in the arm or upper extremities. To ensure the correct diagnosis, your child may also undergo further testing that includes:

X-ray – This will reveal if there are any damages to the bones or joints of the neck and shoulder.

Electromyogram or nerve conduction study – These tests can determine the presence of nerve signals in the upper arm muscles.

Treatment of brachial plexus palsy

Treatments offered by Shriners Hospitals for Children vary and depend upon the severity of the tear and nerve damage. Treatments include:

Occupational and physical therapy 

Both you and your child will work with therapists to learn exercises and stretching to improve range of motion. These exercises and stretching techniques are important to keep the joints and muscles moving as much as possible. These exercises can also be done on a routine basis at home to help prevent your child’s joints and muscles from becoming permanently stiff.

Surgical treatment

Tendon transfer – Tendons, the connective tissue between the muscle and bone, may need to be detached from its normal attachment and reattached in a different area. This reattachment process improves shoulder and wrist motion, along with elbow position and hand grip.

Osteotomy – This is a surgical procedure where your child’s bones are cut and either shortened, lengthened or realigned to improve upper extremity function.

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