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Brachial plexopathy: a clinical and electrophysiological study.
1Department of Neurology, G.B. Pant Hospital, New Delhi 110002, India. vpuri@bol.net.in
Electromyography and Clinical Neurophysiology
|July 1, 2004
Summary
This study analyzed brachial plexus lesions in India, finding that recovery in traumatic cases correlated with electrophysiological findings, unlike in idiopathic cases. This highlights differences in lesion profiles and recovery patterns.
Area of Science:
- Neurology
- Clinical Electrophysiology
- Peripheral Nerve Disorders
Background:
- Brachial plexus lesions, encompassing idiopathic and traumatic etiologies, present significant diagnostic and prognostic challenges.
- Understanding the clinical and electrophysiological characteristics is crucial for effective management in tertiary care settings.
Purpose of the Study:
- To evaluate the clinical and electrophysiological profiles of brachial plexus lesions.
- To compare idiopathic and traumatic brachial plexopathy in terms of lesion localization, severity, and electrodiagnostic findings.
- To investigate the correlation between electrophysiological abnormalities and patient recovery.
Main Methods:
- Retrospective analysis of 38 patients with brachial plexopathy.
- Comprehensive electrophysiological studies including motor and sensory nerve conduction studies, Compound Muscle Action Potentials (CMAP), needle electromyography (EMG), and paraspinal EMG.
- Assessment of disability using the Medical Research Council (MRC) scale and Activities of Daily Living (ADL) scale.
Main Results:
- Idiopathic brachial plexopathy predominantly involved the upper trunk (58.3%), while traumatic plexopathy frequently affected the middle trunk/posterior cord (57.69%) and showed diffuse involvement (30.76%).
- All traumatic plexopathy patients presented with severe disability, compared to 91.66% in the idiopathic group.
- Electrophysiological findings like low CMAP and F wave abnormalities were noted in both groups, with a higher incidence of absent SNAPs (53.8%) and paraspinal muscle involvement (23.0%) in the traumatic group.
Conclusions:
- Electrophysiological abnormalities showed a significant correlation with recovery outcomes in traumatic brachial plexus lesions.
- No such correlation between electrophysiological findings and recovery was observed in the idiopathic brachial plexopathy group.
- The study underscores distinct pathophysiological mechanisms and recovery trajectories between idiopathic and traumatic brachial plexopathy.