Therapeutic strategies for brachial plexus injury

Brachial plexus avulsion (BPA), a severe acute peripheral nerve injury in adults, results in total loss of the motor function in the upper limb. Although immediate re-implantation surgery is widely performed to repair this lesion, the motor function cannot be fully restored. The main cause is that the growth velocity of axon is extremely slow in order to re-innervate the target muscles before atrophy develops. Therefore, the survival of spinal motoneurons (MNs) is considered to be a prerequisite for the recovery of motor function. The introduction of survival-proactive agents with anti-oxidative stress and anti-inflammation properties has emerged as a new approach to the motor function recovery following BPA. In the current review, we summarized the treatments of BPA in both mouse and rat models following re-implantation surgery. Furthermore, the pain treatment options following BPA were discussed.