Phrenic nerve conduction study in patients with traumatic brachial plexus palsy

Phrenic nerve conduction studies were performed to assess the ipsilateral nerve in 100 patients with traumatic brachial plexus palsy. Open exploration and intraoperative recordings of somatosensory evoked potentials and nerve action potentials were used to confirm the level of root lesions. The relationship between C-5 preganglionic root lesion and the functional integrity of the ipsilateral phrenic nerve was examined. The phrenic nerves were normal in 80 cases, partially injured in 7, and severely injured in 13. We found C-5 preganglionic root lesions in 13 (100%) patients with severely injured, 5 (71.4%) with partially injured, and 24 (30%) with normal phrenic nerves. This correlation suggests phrenic nerve conduction study is a useful tool in the diagnosis of C-5 preganglionic root lesions in patients with traumatic brachial plexopathy.