Brachial plexopathy

Alternative names:

brachial plexus dysfunction; neuropathy - brachial plexus

Treatment:

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.

If there is no history of trauma to the area, conservative treatment is indicated by sudden onset, minimal sensation changes with no difficulty in movement, and no test evidence of nerve axon degeneration.

Systemic corticosteroids may be recommended for cases that are secondary to inflammatory lesions (such as brachial amyotrophy, and brachial neuritis).

Surgery may be necessary if the disorder is chronic (long term), if symptoms worsen, if there is difficulty with movement, or if there is evidence that the nerve axon has degenerated. Surgical decompression may relieve an entrapped nerve, or surgical removal of lesions that press on the nerve may help some cases.

Over-the-counter or prescription analgesics may be needed to control pain (neuralgia). Various other medications may be used to reduce the stabbing pains that some persons experience, including phenytoin, carbamazepine or tricyclic antidepressants such as amitriptyline. Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects.

Physical therapy exercises to maintain muscle strength may be appropriate for some people. Orthopedic assistance such as braces, splints, or other appliances may maximize the ability to use the arm. Vocational counseling, occupational therapy, occupational changes, job retraining, or similar interventions may be recommended.

Expectations (prognosis):

The probable outcome is variable; recovery may be incomplete or complete. Recovery takes several months. Nerve pain may be quite uncomfortable and may persist for a prolonged period of time.

Complications:

• partial or complete arm paralysis
• partial or complete loss of sensation in the arm, hand or fingers
• recurrent or unnoticed injury to the hand or arm
• deformity of the hand or arm, mild to severe, leading to contractures

Calling your health care provider:

Call your health care provider if you experience pain, numbness, tingling, or weakness in the shoulder, arm, or hand.