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2.1
Brachial Plexus Neuropathy
Syndrome Brachial Plexus

Presentation

Acquired brachial-plexus neuropathy as the initial presentation of osteomyelitis of the humerus in the neonatal period is described. [ncbi.nlm.nih.gov]

Septic arthritis presenting as brachial plexus neuropathy. BMJ Case Rep 2011 10.1136/ bcr.12.2010.3562. Yuille TD. Limb infections in infancy presenting with pseudoparalysis. Arch Dis Child 1975; 50: 953. Bennet GC, Harrold AJ. [revistas.rcaap.pt]

Entire Body System

  • Arm Pain

    Acute brachial plexus neuropathy is characterized by acute onset of shoulder girdle and arm pain, followed by weakness of the shoulder and arm muscles. [ncbi.nlm.nih.gov]

    Brachial Neuritis is the condition of sudden shoulder and arm pain, followed by weakness or numbness. [remedypainsolutions.com]

    Symptoms: Severe pain in the upper arm or shoulder. Pain usually affecting just one side of the body. After a few hours or days, the pain transitions to weakness, limpness, or paralysis in the muscles of the affected arm or shoulder. [medigoo.com]

    Pain is unaltered by neck or arm movements. Pain is spontaneous, often with no apparent cause. Gradual decrease in pain followed by marked weakness of upper arm. [aafp.org]

    A 36-year-old man with known NF-1 presenting with right shoulder and neck pain with weakness of the arm. [ajnr.org]

  • Episodic Pain

    Abstract Hereditary neuralgic amyotrophy with predilection for the brachial plexus (HNA) is an autosomal dominant disorder associated with recurrent, episodic, painful brachial neuropathies. [ncbi.nlm.nih.gov]

  • Soft Tissue Swelling

    Skin discoloration, pain, tenderness, and soft-tissue swelling may be the main clinical features. The authors present 3 extraordinary cases of brachial plexus neuropathy associated with anticoagulant-induced hemorrhage. [ncbi.nlm.nih.gov]

Skin

  • Skin Discoloration

    Skin discoloration, pain, tenderness, and soft-tissue swelling may be the main clinical features. The authors present 3 extraordinary cases of brachial plexus neuropathy associated with anticoagulant-induced hemorrhage. [ncbi.nlm.nih.gov]

Eyes

  • Small Palpebral Fissures

    Patients had typical features including hypotelorism, small palpebral fissures and a small oral opening. The distribution of the affected members in the pedigree was compatible with autosomal dominant inheritance with high penetrance. [ncbi.nlm.nih.gov]

Musculoskeletal

  • Neck Pain

    I was having intense neck pain for 7 weeks that felt like it was worsening daily. The pain radiated down my arm into my hand. [ihelpbackpain.com]

    Whether it is whiplash from a motor vehicle accident or the chronic neck pain from sitting hunched over a desk all day, massage is frequently sought as a remedy for that all-too-common “pain in the neck.” [academyofclinicalmassage.com]

    […] chest pain, neck pain, and nerve pain, as well as the pain often associated with cancer treatment. [calmarerelief.com]

    There was no neck pain or involvement of bladder or bowel. Examination revealed bilateral wrist-drop with grade 3–4 weakness of the small muscles of the hand, elbow flexors and extensors and shoulder abduction. Upper limb reflexes were absent. [nature.com]

    A 36-year-old man with known NF-1 presenting with right shoulder and neck pain with weakness of the arm. [ajnr.org]

  • Long Arm

    Linkage to markers from the distal long arm of chromosome 17 was established. [ncbi.nlm.nih.gov]

Neurologic

  • Peripheral Neuropathy

    Features of Textbook of Peripheral Neuropathy Include : ̈ Practical yet comprehensiveóan accessible ìgo-toî reference for clinicians ̈ Covers all clinically relevant peripheral neuropathies ̈ Clinical Pearls and Key Points are set off from the text for [books.google.com]

    Abstract We present a patient with a large B cell gastric lymphoma in total remission who, after 4 months, developed a fatal progressive peripheral neuropathy with an unusual early involvement of the right brachial plexus. [ncbi.nlm.nih.gov]

    The term is usually used to mean the same thing as peripheral neuropathy. [disabilitycasereview.com]

    […] brachial plexopathy A peripheral neuropathy caused by damage to the brachial plexus. Clinical findings Pain, numbness, burning and weakness in the shoulder, arm, hand or wrist. [medical-dictionary.thefreedictionary.com]

    The main neurological complications of 1M are lymphocytic meningitis, peripheral neuropathy and encephalomyelitis and they can occur without any classical findings as pharyngitis, adenopathy or splenomegaly. [scielo.br]

  • Neuralgia

    Neuralgia, Parsonage Aldren Turner Syndrome, Amyotrophic Neuralgia, Hereditary Brachial Plexus Neuropathy, Brachial Neuralgias, Brachial Neuritides, Amyotrophic Neuralgias, Neuralgic Amyotrophies, Brachial Plexus Neuritides, Cervicobrachial Neuralgias [xpertdox.com]

    Neuritis; Brachialneuralgie; Cervico Brachial Neuralgia; Cervico-Brachial Neuralgia; Cervico-Brachial Neuralgias; Cervicobrachial Neuralgia; Cervicobrachial Neuralgias; Neuralgia, Amyotrophic; Neuralgia, Brachial; Neuralgia, Cervico-Brachial; Neuralgia [134.130.12.205]

    [Nom commun] Brachial Neuralgias [Nom commun] Neuralgia, Brachial [Nom commun] Neuralgias, Brachial [Nom commun] Cervico-Brachial Neuralgia [Nom commun] Cervico Brachial Neuralgia [Nom commun] Cervico-Brachial Neuralgias [Nom commun] Neuralgia, Cervico-Brachial [idref.fr]

    Neuropatia do plexo braquial (neuralgia amiotrofica) e mononucleose infecciosa : registro de um caso. Arq. Neuro-Psiquiatr. [online]. 1984, vol.42, n.3, pp.289-293. ISSN 0004-282X. http://dx.doi.org/10.1590/S0004-282X1984000300014. [scielo.br]

    My clients nerve inflammation is resolved and their neuralgia heals. [ihelpbackpain.com]

  • Limb Weakness

    Clinical examination revealed bilateral proximal upper limb weakness with wasting and areflexia. The remainder of the neurological examination was normal. [nature.com]

    Three patterns of upper limb weakness were identified, distal limb weakness only (13 patients), global limb weakness that was more marked distally (11 patients), and completely flaccid arm (10 patients). [stepup-speakout.org]

  • Numbness of the Hand

    Other possible signs and symptoms include: Regional muscle weakness Abnormal sensations like burning or tingling Numbness in your hand, arm or shoulder Horner syndrome (affects the nerves of your face and eye) An inability to raise or extend your hand [disabilitycasereview.com]

    My numbness and tingling in both my neck elbow and hands stopped that night after the 3rd treatment. The numbness and tingling have not return. [ihelpbackpain.com]

  • Hand Paralysis

    RIBP ultimately progresses from onset of hand paralysis to full limb paralysis in a range of 0.2 to 5 years. 11 The best approach to minimize the risk of RIBP is to limit RTX dose, dose per fraction, and volume. 12 Treatment is symptomatic and no cure [appliedradiology.com]

    Less recovery than upper plexus lesions Other Pure lower trunk lesions: Tendon reflexes normal Klumpke paralysis: Wasted & weak medial forearm & hand NCV: Nerves commonly affected Median & Ulnar Specific syndromes Neoplasia Metastatic Pancoast Neurofibroma [neuromuscular.wustl.edu]

Workup

Workup Laboratory studies are indicated in brachial neuritis only if systemic disease is suspected on clinical grounds. [emedicine.medscape.com]

Clinical Testing and Workup Certain tests such as nerve conduction studies or electromyography can be used to assess the health of muscles and the nerves that control muscles. [rarediseases.org]

Microbiology

  • Complement Fixing Antibody

    OBJECTIVE: To determine if complement-fixing antibodies to peripheral nerve myelin (anti-PNM antibodies) and terminal complement activation products were increased in serum of patients with brachial plexus neuropathy compared with normal controls. [ncbi.nlm.nih.gov]

Treatment

Treatment of carcinomatous neuropathy is most likely to succeed if the tumor is hormonally sensitive, but radiotherapy may also be effective. Treatment of radiation-induced neuropathy remains largely ineffective. [ncbi.nlm.nih.gov]

Prognosis

Despite the lack of knowledge concerning its etiology, and lack of an effective therapy, the long-term prognosis is excellent. [ncbi.nlm.nih.gov]

[…] recovery of reconstructed plexus can take up to 3 years nerve regeneration occurs at speed of 1mm/day infraclavicular plexus injuries have better prognosis than supraclavicular injuries upper plexus injuries have improved prognosis preservation of hand [orthobullets.com]

Chapters focus on specific disorders or groups of disorders and emphasize differential diagnosis, disease course, treatment, and prognosis. This edition has a new chapter on mitochondrial cytopathies. [books.google.com]

Etiology

The possible viral etiology of giant cell arteritis is considered. We think an immunological rather than ischemic disturbance may have caused the recurrent brachial plexus neuropathy. [ncbi.nlm.nih.gov]

Pathology Etiology post radiation plexitis: usually presents 5-30 months after treatment, generally with doses of ≥6000 cGy viral brachial plexitis, e.g. cytomegalovirus, Coxsackie, herpes zoster, Epstein-Barr virus, parvovirus B19 immune-mediated toxic [radiopaedia.org]

They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]

Brachial plexopathy in this patient was likely related to his diabetes because there was no other obvious etiology; pain and weakness were prominent with relative paucity of sensory symptoms, and there was preceding weight loss, both characteristic features [care.diabetesjournals.org]

Epidemiology

An evaluation of the clinical course of three children, together with epidemiologic data, suggests that early lumbar punctures and an extensive search for an infecting viral agent, notably coxsackievirus B, are warranted. [ncbi.nlm.nih.gov]

The discussion covers the phenotype spectrum, epidemiology, mode of inheritance, pathogenesis, and clinical profile of each condition, all of which is accompanied by a wealth of illustrations. [books.google.com]

Epidemiology Brachial plexitis is more commonly seen in men between 30 and 70 years of age and is bilateral in 10-30% of patients 3. [radiopaedia.org]

[…] indicus Flexor pollicus longus Differential diagnosis: Other involvement of supraclavicular lower plexus Thoracic outlet syndrome, Neurogenic Pancoast syndrome Neuralgic Amyotrophy 10 Nosology: Also called Parsonage-Turner syndrome Brachial Neuritis Epidemiology [neuromuscular.wustl.edu]

Midha R (1997) Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery 40;1182–1189 PubMed CrossRef Google Scholar 6. [link.springer.com]

Pathophysiology

• Although the exact pathophysiology is unclear, available evidence points to an autoimmune pathogenesis, superimposed on a mechanically-induced vulnerability of the nerves with an underlying genetic susceptibility. • Diagnosis of the classic form is [medlink.com]

It was first described in 1966 by Stoll and Andrews. 1 The pathophysiology of RIPN is not fully understood, though it is thought that direct nerve injury results from radiation-induced capillary network disruption. [appliedradiology.com]

Pathophysiology Brachial neuritis (BN) exists in an inherited and an idiopathic form. [emedicine.medscape.com]

Clinical and pathophysiological concepts of neuralgic amyotrophy. Nat Rev Neurol. 2011;10:315-322. http://www.ncbi.nlm.nih.gov/pubmed/21556032 Feinberg JH, Radecki J. Parsonage-Turner syndrome. [rarediseases.org]

Horner's : T1 involvement Medial Brachial Fascial Compartment Syndrome Medial brachial fascial compartment: Anatomy Extends from the clavicle to the elbow Houses terminal nerves of brachial & plexus & axillary vessels Formed by medial intermuscular septum Pathophysiology [neuromuscular.wustl.edu]

Prevention

Elective caesarean delivery did not prevent a typical postpartum attack. CONCLUSIONS: Inflammation, probably immune, appears pathogenic for some if not all attacks of HBPN. [ncbi.nlm.nih.gov]

Prevention methods vary depending on the cause of your BPN. Once you’ve been diagnosed with BPN and your doctor determines the cause, he or she can provide you with prevention methods. [healthline.com]

To prevent compression of the dependent brachial plexus, an “axillary roll” is placed. The term “axillary roll” is a misnomer. The roll is actually a “chest roll” and should never be placed in the axilla. [openanesthesia.org]

The ASA task force recommendations to prevent neuropathies are reviewed. [ispub.com]

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