Pediatric Brachial Plexus
The brachial plexus is a group of nerves that begins in the neck and gives feeling and movement to the shoulder, arm, forearm, and hand. Signs of damage in this area include: a limp arm or an arm with no muscle control in the shoulder, arm, or hand. Infants may also lack feeling in their hand and arm. These kinds of injuries in infants are not painful.
The brachial plexus nerves stretch between the neck and shoulder.
- EMG (electromyography) measures how the nerve and muscle work together.
- SSEPs (somatosensory evoked potentials) measures how the nerve communicates between the spinal cord and brain.
- NAPs (nerve action potentials) tests for nerve conduction across the injured site.
- Myelogram CT (myelogram computer tomography) measures spinal cord and nerve root damage by taking x-rays after a dye is injected into the spinal cord.
- MRI (magnetic resonance imaging) provides a detailed picture of the spinal cord and nerve roots.
- Avulsion: The nerve root separates from the spinal cord; requires surgery.
- Neuroma-in-continuity with Good Conduction: This is from damage to the nerve, but a message still travels through it. The nerve will grow back over time.
- Neuroma-in-continuity without Conduction: There is damage to the never, and messages are not able to travel through it. The nerve will need to be repaired with surgery.
In most cases, it is only during surgery that we can tell if a message is able to travel through damaged nerves or not.
Types of Repair for Brachial Plexus Injury
- External Neurolysis: The surgeon remove the scar tissue around the nerve.
- Nerve Grafting: The damaged part of the nerve is removed or bypassed and replaced with a nerve graft. A nerve graft is taken from the leg, arm or neck at the time of surgery.
- Neurotization: A nerve from another place in the body, such as the diaphragm, the neck, or the chest wall, is used to repair the damaged nerve.