Plexopathy

Brachial plexopathy, which affects nerves in the C5-T1 segmental distribution, leads to weakness, sensory loss, and loss of tendon reflexes in the corresponding regions of the body. To confirm the clinical diagnosis, electrodiagnostic studies (EMG) are necessary. On the other hand, lumbar plexopathy affects the distribution of spinal segments L1-L4 and results in weakness, sensory loss, and reflex changes in obturator- and femoral-innervated territories. Meanwhile, sacral plexopathy affects segments L5-S3, causing the same abnormalities and leading to weakness and sensory loss in the gluteal (motor only), peroneal, and tibial nerve territories.

The usual characteristics of a mass lesion are the infiltration of perineural fat and the presence of abnormal MR imaging features on short tau inversion recovery (STIR) or fat-saturated T2-weighted fast-spin-echo (FSE) images, abnormal appearance of the intraneural fascicular pattern, and/or abnormal contrast enhancement on fat-saturated T1-weighted images. If the quality of the MR imaging is sufficient for diagnostic purposes, additional CT or positron emission tomography (PET) scans are rarely required, except in cases of post-traumatic brachial plexopathy, where MR imaging and postmyelographic CT are used together as complementary diagnostic tools.

Causes

There are several possible reasons behind damage to the brachial plexus:

  • Direct injury to the nerve
  • Inflammatory conditions (a virus or immune system problem)
  • Damage caused due to radiation therapy
  • Stretching injuries (including birth trauma)
  • Pressure from tumors in the area (especially from lung tumors)
  • Brachial plexus dysfunction may also be associated with:
  • General anesthesia, used during surgery
  • Birth defects that put pressure on the neck area
  • Exposure to toxins, chemicals, or drugs

In some cases, no cause can be identified.

Symptoms

Common symptoms of plexopathy include the following:

  • Numbness of the shoulder, arm, or hand
  • Weakness of the shoulder, arm, hand, or wrist
  • Shoulder pain
  • Tingling, burning, pain, or abnormal sensations (location depends on the area injured)

Treatment

Treatment for Plexopathy is aimed at improving the underlying cause. Doctors also focus on helping patient use hand and arm. In some cases, the condition does not require any treatment. The condition gets better on its own.

Some of the common treatment options for the condition include any of the following:

  • Medicines to control pain
  • Nerve block (it involves injecting medicine is injected into the area around the nerves to minimize pain)
  • Physical therapy to maintain overall muscle strength.
  • Surgery aiming at repairing nerves or removing something pressing on the nerves
  • Braces, splints, or other devices to facilitate use of arm
  • Occupational therapy or counseling (suggest workplace changes).
  • Medical conditions (kidney disease and diabetes) can damage nerves. The treatment is directed to relieve underlying medical condition.

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