What You Should Know About Brachial Plexus Injuries
Although it is always distressing to find out your child has sustained any kind of birth injury, the good news is that not all birth injuries result in lifelong problems for the child. In many cases, brachial plexus injuries (BPI) are one of those types of birth injuries. In some cases, they are mild injuries that will go away with time and/or treatment, but about 10% of BPI’s are severe enough to result in permanent disabilities.
Brachial plexus injuries are an injury that occurs when the nerves in the brachial plexus are torn, stretched, or compressed. The brachial plexus is a network of nerve groups which run from the spinal cord to arms, shoulders, wrists, and fingers. These nerve groups control movement and sensation in these areas. BPI’s are most often caused when a person’s shoulder is forced down while their head is forced away from the shoulder. Although BPI’s are a common type of birth injury, they can also occur while playing contact sports (particularly football or wrestling), during falls, during car or motorcycle accidents, due to inflammation, or if a tumor has formed and is exerting pressure on these nerves.
Symptoms of a BPI include a limp or paralyzed arm, muscle weakness, numbness in an arm or hand, or lack of muscle control in a hand, arm, or shoulder.
BPI’s exist in four different categories. Neurapraxia is the least severe and most common type of BPI. With neurapraxia, nerves could be stretched or the nerve’s protective covering could be damaged, but ultimately the nerve itself is unharmed and symptoms should clear up on their own in a few months.
Neuroma is the second most mild type of BPI. With neuroma, there is an injury on the nerve and scar tissue forms around the injury, making it more difficult for the nerve to deliver signals to the muscles. If there is only a small amount of scar tissue, it may clear up on its own over time, but surgery might be required to remove larger amounts of scar tissue. Many cases of neuroma can be treated by applying hot or cold compresses or alcohol is applied to impacted areas. The National Institute of Health has reported a 50% success rate of using this method to treat neuroma.
A rupture is a type of BPI where a nerve is at least partially torn, but not at the spinal cord. This is the second most severe type of BPI and surgery will be needed to correct it as soon as possible.
Avulsions are the most severe type of BPI. Avulsions occur when the nerve root is completely torn away from the spinal cord. This type of injury cannot heal on its own and will require surgical treatment.
If surgery is required to treat a BPI, it’s important to have that done as soon as possible. If 18 months or more have passed from the time of the injury, it may not be possible for muscles that have not connected with nerve tissue to be reconnected. Nerve repair surgery can be performed on infants as young as three months and nerve repair is usually done between the ages of three and six months.