Brachial plexopathy is an injury to the brachial plexus, an arrangement of nerve fibers that extends from the spine, through the neck and armpit, to the arm. The brachial plexus nerves carry nerve signals to the skin and muscles of the chest, shoulders, arms, and hands. Brachial plexus injury is usually caused by overstretching or tearing of nerve fibers, presenting as impaired muscle control or sensation.
Brachial plexopathy is caused by physical trauma of some sort. In adults, the most common causes are sports injuries, motorcycle or ATV accidents, falls, direct violence or gunshot wounds, or violent pulling of the arm. Babies can also suffer from brachial plexopathy, which sometimes results from a difficult delivery or failed forceps delivery.
There are degrees of severity of brachial plexopathy, as with any nerve damage. In its mildest form, brachial plexus injury can be a temporary condition that can be treated simply through rest and is completely reversible within a matter of months. Other types of injuries may require physical or occupational therapy, and some require surgery. Anti-seizure medications are sometimes prescribed to control any nerve pain. In most cases of brachial plexopathy, the prognosis is good for full or near-full recovery.
Brachial plexopathy can present with muscle weakness or poor muscle control in the hand or arm. Other possible symptoms include altered sensation, impaired reflexes, and paralysis of the arm or hand. Brachial plexus injury can cause Erb's palsy, in which the arm hangs limp at the side of the body while the forearm is extended palm up. A person with Erb's palsy cannot move their arm to any other position. Another disorder caused by some cases of brachial plexopathy is Klumpke's palsy, in which the muscles of the forearm and hand are paralyzed, usually causing a characteristic clawed hand in the patient.
Most babies with brachial plexus injury recover or improve within six months. Those who show signs of recovery can usually be treated with range-of-motion exercises performed by their parents and regular examination by a doctor. Babies who show no signs of recovery usually require surgery.