Brachial plexopathies

The main objective of this article is to offer a regional approach to brachial plexus assessment because, although the brachial plexus is the largest and most complex peripheral nervous system structure, most of its disorders involve only a portion of it. Consequently, regional assessment typically localizes and characterizes the lesion.

The sensory axons traversing each region are known and provide localizing information.

Because localization dictates the differential diagnosis and the resulting initial clinical management, examining physicians must first localize the lesion. Localization of a brachial plexus lesion requires an appreciation of brachial plexus anatomy, lesion classification, and the routes traversed by the various axons composing the brachial plexus, especially the sensory axons. This information is reviewed in this article and followed by discussions of several brachial plexus disorders, especially those with regional predilections.