Transient brachial diplegia (crossed paralysis): etiopathogeny and differential diagnosis

The present paper presents three short clinical observations of patients with cerebral trauma and concussion also showing transient motor deficits of upper limbs but no sensory disorders. The etiopathogenesis of motor brachial deficits is also discussed. The conclusion is that the sudden anterior flexion of the head determines an instantaneous hit of the pyramidal bulbar decussation (the upper part) to the odontoid apophysis or to the anterior margin of the occipital foramen. Recovery depends on the severity of trauma. This clinical entity is very rare. There are other pathologic causes which can trigger a transient brachial diplegia, thus, requiring a differential diagnosis.