Khadilkar Satish V, Khade Snehaldatta S
Department of Neurology, Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.
Ann Indian Acad Neurol. 2013 Jan;16(1):12-8. doi: 10.4103/0972-2327.107675.
Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Idiopathic hypertrophic brachial neuritis, a rare condition, is usually painless to begin with, unlike IBN. Hereditary neuralgic amyotrophy is an autosomal-dominant disorder characterized by repeated episodes of paralysis and sensory disturbances in an affected limb, which is preceded by severe pain. While the frequency of the episodes tends to decrease with age, affected individuals suffer from residual deficits. Neurogenic thoracic outlet syndrome affects the lower trunk of the brachial plexus. It is diagnosed on the basis of electrophysiology and is amenable to surgical intervention. Cancer-related brachial plexopathy may occur secondary to metastatic infiltration or radiation therapy. Traumatic brachial plexus injury is commonly encountered in neurology, orthopedic, and plastic surgery set-ups. Trauma may be a direct blow or traction or stretch injury. The prognosis depends on the extent and site of injury as well as the surgical expertise.
臂丛神经损伤可由创伤、炎症、恶性肿瘤及相关并发症引起。当前主题涉及臂丛神经病变的各种形式、其临床特征、病理生理学、影像学表现及治疗。特发性臂丛神经炎(IBN)通常在感染等前驱事件后发生,常见表现为上肢突发疼痛性不对称无力,伴有肩胛带和手臂肌肉萎缩。与IBN不同,特发性肥厚性臂丛神经炎是一种罕见疾病,起初通常无痛。遗传性神经痛性肌萎缩是一种常染色体显性疾病,其特征为受累肢体反复出现麻痹和感觉障碍,之前会有严重疼痛。虽然发作频率往往随年龄增长而降低,但患者会遗留功能缺陷。神经源性胸廓出口综合征影响臂丛神经的下干。它通过电生理学诊断,适合手术干预。癌症相关的臂丛神经病变可能继发于转移浸润或放射治疗。创伤性臂丛神经损伤在神经科、骨科和整形外科中较为常见。创伤可能是直接打击、牵引或拉伸损伤。预后取决于损伤的程度和部位以及手术专业水平。