Simon Neil G, Franz Colin K, Gupta Nalin, Alden Tord, Kliot Michel
St. Vincent's Clinical School, University of New South Wales, Australia.
Department of Physical Medicine and Rehabilitation, Northwestern University, Illinois, USA; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Illinois, USA.
World Neurosurg. 2016 Jan;85:325-32. doi: 10.1016/j.wneu.2015.09.027. Epub 2015 Sep 25.
Brachial plexus trauma (BPT) often affects young patients and may result in lasting functional deficits. Standard care following BPT involves monitoring for clinical and electrophysiological evidence of muscle reinnervation, with surgical treatment decisions based on the presence or absence of spontaneous recovery. Data are emerging to suggest that central and peripheral adaptation may play a role in recovery following BPT. The present review highlights adaptive and maladaptive mechanisms of central and peripheral nervous system changes following BPT that may contribute to functional outcomes. Rehabilitation and other treatment strategies that harness or modulate these intrinsic adaptive mechanisms may improve functional outcomes following BPT.
臂丛神经损伤(BPT)常影响年轻患者,并可能导致持久的功能缺陷。BPT后的标准治疗包括监测肌肉再支配的临床和电生理证据,并根据是否存在自发恢复情况做出手术治疗决策。越来越多的数据表明,中枢和外周适应可能在BPT后的恢复中发挥作用。本综述重点介绍了BPT后中枢和外周神经系统变化的适应性和适应不良机制,这些机制可能影响功能结局。利用或调节这些内在适应机制的康复和其他治疗策略可能会改善BPT后的功能结局。