Brachial Plexus and Peripheral Nerve Injuries

Also known as: peripheral neuropathy, peripheral nerve injuries

What are brachial plexus and peripheral nerve injuries?

The peripheral nervous system includes a network of nerves that connect the brain and spinal cord to the muscles, skin and internal organs. Put simply, the peripheral nervous system is the electrical wiring of our bodies. It is composed of sensory nerves that receive input from our surroundings, e.g., touch, temperature, pressure, pain, etc., and motor nerves that send information to our muscles.

What is the brachial plexus?

The brachial plexus is a component of the peripheral nervous system. It is a network of nerves located in the neck that controls function of the arm (shoulder to fingertip) and carries sensory information—from the fingertips to the shoulder—back to the brain.

What are some causes of peripheral nerve injuries?

Causes of peripheral nerve injury include:

  1. Compression—too much pressure on the nerve (from surrounding scar tissue or swollen muscles)
  2. Crush/percussion injury (from bone fractures or gunshot wounds)
  3. Laceration (a cut or tear in the nerve, usually from penetrating trauma)
  4. Stretch injury (usually from traction on a limb)
  5. Electrical injury
  6. Frostbite injury
  7. Toxins (sugar, alcohol, heavy metals, infections)

What are some causes of brachial plexus injury?

The location of the brachial plexus increases its risk for injury. Stretch or impact of the neck, shoulder or arm can lead to injuries to the nerves of the brachial plexus. Injury can occur during the childbirth process. Two main risk factors for birth-related brachial plexus injury are shoulder dystocia and macrosomia.

Shoulder dystocia refers to the shoulder being stuck in the birth canal, and macrosomia refers to a high birth weight/larger than normal baby. In older patients, other causes for brachial plexus injury may include motor vehicle accidents, sports injuries, penetrating injuries (stab wounds/gunshot wounds) or tumors that may affect the nerves.

What are the symptoms of brachial plexus or peripheral nerve injuries?

In the infant, injuries to the brachial plexus may cause weakness or paralysis of the affected arm. Older children with brachial or other peripheral nerve injury may complain of numbness or tingling while severe injuries can lead to weakness or even complete loss of sensation and paralysis of the affected part of the body.

What are brachial plexus and peripheral nerve injury care options?

Treatment of peripheral nerve injuries is best managed by a multidisciplinary team that includes peripheral nerve surgeons (may be a plastic surgeon, orthopedic surgeon, or neurosurgeon) and occupational/physical therapists skilled in the care of these types of injuries.

Some minor nerve injuries can heal on their own. More severe nerve injuries may require surgery. The surgical procedures range from freeing the nerves from scar to repair or reconstruction of the nerves. Reconstruction of injured nerves can be performed with grafts from another part of the body, or transfers from a working muscle to a non-functioning muscle. In many cases, rehabilitation is needed to facilitate full recovery.

Reviewed by: Aaron Berger, MD

This page was last updated on: March 31, 2021 08:55 AM

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