What is Brachial Plexus?

The brachial plexus is a network of nerves located between the shoulder and neck that send messages from the brain to control the muscles of the shoulder, arm, elbow, wrist, hand and fingers. Brachial plexus palsy is the general term for any injury to the brachial plexus nerves. Erb's Palsy is an upper brachial plexus injury. Klumpke's Palsy is an injury to the lower parts of the arm and Horner's Syndrome is partial facial paralysis.

What are the various types of brachial plexus injuries?

There are four different types of brachial plexus injuries:
 
-Stretch or praxis :This is the least damaging type of injury. Stretch injuries will spontaneously recover in 1-2 years of age with 90-100% return of function. Improvement should be noted within the first three months.

-Neuroma :This happens when the nerve has tried to heal and has scarred in the process. This scar tissue puts pressure on the injured nerve and may impair movement. Surgical intervention is often needed to remove the scar tissue.

-Rupture :A rupture means that the nerves have been torn from the shoulder, but not where they attach to the spine. Surgery is again often required.

-Avulsion :This means that the brachial nerves are torn from the spinal cord as well. An avulsion is the most severe type of injury. Surgery is almost always required to see any gain of function in the arm.


What happens when the brachial plexus is injured?

When the brachial plexus is injured, the brain no longer has any way to send messages to the shoulder, arm and hand. As a result, the arm suffers some degree of paralysis. Children with BP injuries are effected in a lot of different ways.Here are some examples of how the injury might look in different children:

- No muscle control and no feeling in the arm or hand
- Ability to move arms but with little control over the wrist or hand
- Use of hands but no use of shoulder or elbow muscles
- Paralysis in entire arm and hand and fingers hang limp (most severe cases)
- Facial paralysis on affected side
- Inability to sit up without assistance
- Inability to crawl without therapeutic devices