How to Test for Brachial Plexus Injury?

If you or your child has suffered a shoulder or arm injury, it’s important to be aware of the possibility of brachial plexus injury. This condition, which occurs when the nerves around the shoulder are damaged, can lead to weakness or paralysis in the affected arm. While most cases of brachial plexus injury will resolve on their own over time, severe cases may require surgery. If you’re concerned that your child may have this condition, here’s what you need to know about how to test for brachial plexus injury.

Preparing for Your Appointment

Several tests can be used to determine the type and severity of brachial plexus injuries. Be sure to ask whether you need to prepare for these tests when you make your appointment. You may need to stop taking certain medications for a few days or avoid using lotions on the day of the test.

If possible, bring a family member or friend. Sometimes it’s hard to absorb all the information you receive during an appointment. The person who accompanies you may remember something you forgot or missed.

You can also make the most of your appointment by:

Describe all your symptoms, including how you were injured, how long you’ve had them, and whether they have gotten worse.

Write down any medications, vitamins, or supplements you take.

Feel free to ask questions. When a child or adult suffers a brachial plexus injury, there are several options for restoring function. Consult your doctor about all the options available to you or your child. When you run out of time, ask your doctor to call you later or to speak with a nurse.

Examining Your Brachial Plexus Injuries

A patient with a brachial plexus injury must be evaluated and treated within an appropriate timeframe, typically within 6 to 7 months after the injury. A muscle that has been without nerve input for a long time is less likely to function normally in the future. No matter whether the muscle regains its nerve signals, this remains true.

Brachial plexus injury treatment depends on the type of injury, whether it’s a tear, or a damaged nerve, and the location of the injury. Minor brachial plexus injuries may be recommended with nonsurgical treatment like physical therapy.

Severe brachial plexus injuries may need a more serious approach. Those who suffer brachial plexus injuries along with other symptoms such as chronic pain, stiff muscles, and other damages like injuries around major nerve branches, especially spinal nerves may need to be checked with diagnostic tests and depending on the medical professional, may proceed with surgical treatment.

Physical Examination

To diagnose a brachial plexus injury and determine if any associated injuries exist, your doctor will perform a comprehensive clinical examination. The physician will examine all nerve groups controlled by the brachial plexus to determine the specific location and severity of the injury.

Your doctor can identify potential nerve injuries by identifying the pattern of nerves from the brachial plexus that control various muscles in the arm and hand. There are several nerve groups in the brachial plexus that your doctor will examine.

Moreover, some patients display specific signs that indicate the location of the nerve injury:

  • A narrowing of the pupil, drooping of the eyelid, and inability to sweat (Horner’s syndrome) indicate that the injury is close to the spinal cord.
  • When the doctor taps along the affected nerves (Tinel sign), the pain feels like it is coming from farther away from the spinal cord. Eventually, if the location of the Tinel sign moves to the hand, it signifies an injury that is healing.
  • Your doctor will also check the stability and range of motion of your arm and shoulder during the physical examination.

Imaging Tests

X-rays. This imaging test allows for the clear visualization of dense structures, like bones. To rule out associated fractures, X-rays of the neck, chest, shoulder, and arm are taken. In order to check for injuries to the lungs or ribs, chest x-rays are taken. During a chest x-ray, your doctor may recommend pulmonary function testing with the assistance of a pulmonologist to rule out damage to the nerves that control deep breathing if you are unable to breathe deeply.

Computed Tomographic (CT) scan. Tests such as this are considered the most reliable for detecting spinal nerve avulsions. In order to see the injury on the CT image more clearly, contrast dye is injected around the spinal cord in the neck. A CT scan is typically performed at least three to four weeks after an injury to prevent blood clots from forming around the nerve root. Magnetic resonance imaging (MRI) may also be used instead of, or in addition to, a CT scan in certain centers.

Nerve Conduction Study. They measure nerve conduction and muscle activity. As diagnostic tools, they can confirm the diagnosis, locate the nerve injury, characterize its severity, and determine the rate of nerve recovery. Three to four weeks after an injury, an electrodiagnostic exam is performed. It allows any nerve degeneration to be detected. Electrodiagnostic studies are repeated 2 to 3 months after the initial study and then periodically thereafter to determine whether the nerves are recovering.

Other Questions About Brachial Plexus Injuries

What Is the Brachial Plexus?

A brachial plexus is a network of nerves that originate in the cervical (neck) and upper extremity sections of the spinal cord (C5-T1), connecting to the nerves in the arm. The nerves of the brachial plexus extend to the skin and are sensory. They warn you when the pan in your hand is too hot to handle, for instance.

What Is a Brachial Plexus Injury?

Stress, pressure, and being stretched too far can all lead to injuries to the brachial plexus. Cancer or radiation can also damage the nerves. Injuries to the brachial plexus can happen to babies during birth. When the brachial plexus is injured, it cuts off all or part of the communication between the spinal cord and the arm, wrist, and hand. As a result, you may not be able to move your arm or hand. Injury to the brachial plexus can also result in a complete loss of sensation.

What Is a Brachial Plexus Neuropraxia?

It is referred to as neuropraxia when nerves are stretched to the point of injury. Both compression and traction can cause this injury. Brachial plexus nerve roots are compressed in a compression injury, usually as a result of the rotation of the head. The most common form of compression neuropraxia is found in the elderly. Traction neuropraxia occurs when the nerve is pulled downward. The injury is less common than compression neuropraxia but is more common among adolescents and young adults.

What Is a Brachial Plexus Rupture?

A ruptured brachial plexus occurs when the nerve is torn, either partially or totally. The injury is more severe than neuropraxia. Ruptures can cause weakness in the shoulder, arm, or hand and even make certain muscles inoperable. In addition, they can cause severe pain.

What Is a Brachial Plexus Neuroma?

Scar tissue can sometimes form when nerve tissue is injured, such as from a cut during surgery. This kind of scar tissue is called a neuroma, and it can cause a painful knot on one of the brachial plexus nerves.

What Is Brachial Neuritis?

Brachial neuritis, also known as Parsonage-Turner syndrome, affects the nerves of the brachial plexus. An individual suffering from this syndrome experiences sudden, severe shoulder and upper arm pain, followed by weakness, muscle loss, and even loss of sensation. Usually, the shoulder and arm are affected, but the diaphragm and legs may also be affected. The cause of brachial neuritis is unknown but could be caused by infections, injuries, childbirth, or other factors.

What Is a Brachial Plexus Avulsion?

When the root of a nerve is completely separated from the spinal cord, it is called an avulsion of the brachial plexus. Traumatic brachial plexus injuries from a car or motorcycle accident usually result in an injured nerve. An avulsion from a traumatic brachial plexus injury is often more painful than ruptures, this kind of brachial plexus injury can cause severe pain and can most likely affect nerve function. Due to the difficulty and usually impossibility of reattaching the root to the spinal cord, avulsions can cause permanent weakness, paralysis, and loss of feeling.

What are the Causes of Brachial Plexus Injuries in Adults?

Among the causes of brachial plexus injuries in adults are blunt trauma, from motor vehicle accidents; athletic injuries, from contact sports; gunshot wounds; medical trauma; cancer; and radiation therapy.

What Are Treatments for Brachial Plexus Injuries?

Mild brachial plexus injuries don’t need any major treatment plans unlike for more severe injuries. Severe brachial plexus injuries may need a certain surgical procedure included in a patient’s treatment program. Surgical procedures like a nerve graft, nerve transfer, nerve repair, and other procedures can be done after a physician performs a brachial plexus injury diagnosis.

Conclusion

If you think you or a loved one may have suffered from a brachial plexus injury, it’s important to visit a medical professional as soon as possible. The sooner the injury is diagnosed and treated, the better the outcome for the patient is likely to be. However, if you have already been diagnosed with this type of injury and are looking for help managing its effects, don’t hesitate to reach out to qualified experts.

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