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Alternative namesNeuropathy - brachial plexus; Brachial plexus dysfunction
DefinitionBrachial plexopathy is decreased movement or sensation in the arm and shoulder, caused by impaired function of the brachial plexus (a nerve area that affects the arm).
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.
It may be related to pressure caused by congenital abnormalities that affect the cervical ribs and can also sometimes be associated with exposure to toxins , chemicals, or drugs.
Rarely, it is caused by an inflammatory condition. In some cases, no cause can be identified. The mechanical factors (pressure) may be complicated by ischemia (lack of oxygen caused by decreased blood flow) in the area.
Signs and tests
Neuromuscular examination of the arm, hand, and wrist indicates brachial plexus dysfunction. Reflexes may be abnormal in the arm. Specific muscle losses may indicate the portion of the brachial plexus that has been damaged.
Variable deformities may develop in the arm or hand, and loss of muscle mass (atrophy) may be profound. Detailed history may be needed to determine the possible cause of the problem.
Treatment is aimed at maximizing independence. The cause should be identified and treated as appropriate. In some cases, no treatment is required and recovery is spontaneous.
Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects. If pain is severe, a pain specialist should be consulted in order to make sure all options for pain treatment are considered.
Vocational counseling, occupational therapy, occupational changes, job retraining, or similar interventions may be recommended in some cases.
Expectations (prognosis)The probable outcome is variable depending on the cause. Recovery may be incomplete or complete and takes several months. Nerve pain may be quite uncomfortable and may persist for a prolonged period of time.
Calling your health care providerCall your health care provider if you experience pain, numbness , tingling or weakness in the shoulder, arm, or hand.
PreventionPrevention is varied, depending on the cause.
Update Date: 8/3/2002Lucas Restrepo, M.D., Department of Neurology, Johns Hopkins Hospital, Baltimore, MD. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT