Brachial plexopathy is injury of the brachial plexus, an arrangement of nerve fibers leading from the spine, through the neck and armpit, and into the arm. The nerves of the brachial plexus carry nervous signals to the skin and muscles of the chest, shoulder, arm, and hand. Brachial plexus injury is usually caused by excessive stretching or tearing of the nerve fibers, and presents as impaired muscular control or sensation.
Brachial plexopathy is caused by physical trauma of some type. In adults, the most common causes are sports injuries, motorcycle or all terrain vehicle (ATV) accidents, falls, direct violence or gunshot wounds, or violent pulling on the arm. Infants can also suffer from brachial plexopathy, which sometime results from difficult childbirth or botched forceps delivery.
There are degrees of severity of the condition, as with any nerve damage. At its mildest, brachial plexus injury may be a temporary condition that can be treated simply through rest, and is completely reversible within months. Other types of injury may require occupational or physical therapy, and some require surgery. Sometimes, anticonvulsant drugs are prescribed to manage any nerve pain. In most cases of brachial plexopathy, the prognosis is good for full or near-full recovery.
Brachial plexopathy can present with muscular weakness or poor muscle control in the hand or arm. Other possible symptoms include impaired sensation, impaired reflexes, and paralysis of the arm or hand. Brachial plexus injury can cause Erb's palsy, in which the arm hangs limp by the side of the body, while the forearm is extended with the palm facing up. A person with Erb's palsy is unable to move his or her arm into any other position. Another disorder caused by some cases is Klumpke's paralysis, in which the muscles of the forearm and hand are paralyzed, usually causing a characteristic clawed hand in the patient.
Most infants suffering from brachial plexus injury recover or improve within six months. Those showing signs of recovery can usually be treated with range of motion exercises performed by their parents and regular examination by a physician. Infants who do not show recovery signs typically require surgery.