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Spinal Cord Injury Paralysis Resource Center

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Brachial Plexus Injury

Brachial plexus injuries are caused by excessive stretching, tearing, or other trauma to a network of nerves from the spine to the shoulder, arm, and hand. Symptoms may include a limp or paralyzed arm, loss of muscle control in the shoulder, arm, hand, or wrist, and lack of feeling or sensation in the arm or hand. Injuries often occur secondary to vehicular accidents, sports injuries, gunshot wounds, or surgeries; many brachial plexus injuries happen during birth, if the baby's shoulders become impacted during the birth process (called shoulder dystocia), causing the brachial plexus nerves to stretch or tear.

Some brachial plexus injuries may heal with little or no treatment. Many children improve or recover by 3 to 4 months of age; physical and occupational therapies are usually employed, especially range of motion. Some who appear to be recovered at 3-4 months of age will have secondary issues months or years later.

Treatment for brachial plexus injuries includes occupational or physical therapy and, in some cases, surgery. The site and type of brachial plexus injury determine the prognosis. For avulsion (tears) and rupture injuries there is no potential for recovery unless surgical reconnection is made in a timely manner. For neuroma (scarring) and neuropraxia (stretching) injuries the potential for recovery is more encouraging. Most patients with neuropraxia injuries recover a significant amount of function.

The major area of concern to most people with brachial plexus injures is often management of pain, which can be chronic and extreme, and which does not generally respond well to many painkillers.

Those with a birth related brachial plexus injury vary widely regarding pain. Some experience no pain, as their sensation is diminished; others are hypersensitive to pain as well as to any stimulus. Some may eventually experience pain on the unaffected side because they chronically overuse their uninjured arm for everyday activities.

According to the United Brachial Plexus Network, obstetrical injuries of this sort are not reported to the Centers for Disease Control; therefore, many cases are incorrectly diagnosed or referred to as Erb's Palsy.

Sources: United Brachial Plexus Network, Brachial Plexus Palsy Foundation, National Institute of Neurological Disorders and Stroke.

A Reeve Foundation Fact Sheet on Brachial Plexus & Peripheral Nerve (PDF)

American Society for Surgery of the HandThe American Society for Surgery of the Hand (ASSH) is a specialty medical society for hand surgeons around the world.

Brachial Plexus Palsy FoundationIs a non-profit organization designed to provide funds for the research and education of brachial plexus in infants and children. The foundation offers a list of clinics and specialists.

Mayo Clinic: Brachial PlexusMayo Clinic is a not-for-profit medical practice dedicated to the diagnosis and treatment of virtually every type of complex illness. Mayo Clinic staff members work together to meet your needs. You will see as many doctors, specialists and other health care professionals as needed to provide comprehensive diagnosis, understandable answers and effective treatment.

NINDS Brachial Plexus Information PagesOffers a multitude of fact sheets on brachial plexus.

United Brachial Plexus Network Provides information, support and leadership for families and those concerned with brachial plexus injuries worldwide. Features an online registry, publications and informational materials to increase awareness of the disorder and to educate medical and legal professionals. United Brachial Plexus Network, 1610 Kent Street, Kent, OH 44240; toll-free 1-866-877-7004

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.