Alfonso I, Papazian O, Grossman J A
Brachial Plexus Palsy Center, Miami Children's Hospital, Florida, USA.
Rev Neurol. 1998 Aug;27(156):258-63.
The brachial plexus originates from C5 to T1 spinal segments. The brachial plexus includes the ventral ramus, trunks, divisions, cords and branches.
Brachial plexus injuries produce clinical syndromes. The Duchenne-Erb syndrome is the most frequent presentation of obstetric brachial plexus injury. The differential diagnosis of brachial plexus palsy include decreased arm movements due to pain, or weakness caused by a lesion of the nervous system outside in the brachial plexus, or by a lesion in the brachial plexus due to non-obstetrical causes. Management of these patients initially includes considering the possibility of clavicular and humeral fractures and posterior subluxation of the shoulder; and subsequently considering the possibilities of subscapularis muscle contraction or posterior shoulder subluxation in patients that develop internal rotation contracture of the shoulder; or flexion, pronation or supination contracture in patients with forearm deformation. Treatment consist of physical therapy, administration of botulinum toxin, electrical stimulation, neurolysis, nervatization, removal of neuromas and nerve grafting, treatment of fractures and subluxation, release of muscle contracture and tendon transplantation.
臂丛神经起源于C5至T1脊髓节段。臂丛神经包括前支、干、股、束和分支。
臂丛神经损伤会产生临床综合征。杜兴-埃尔布综合征是产科臂丛神经损伤最常见的表现形式。臂丛神经麻痹的鉴别诊断包括因疼痛导致的手臂活动减少，或由臂丛神经外的神经系统病变、非产科原因导致的臂丛神经病变引起的无力。这些患者的治疗初期包括考虑锁骨和肱骨骨折以及肩关节后脱位的可能性；对于出现肩部内旋挛缩的患者，随后考虑肩胛下肌收缩或肩关节后脱位的可能性；对于前臂畸形的患者，考虑屈曲、旋前或旋后挛缩的可能性。治疗方法包括物理治疗、肉毒杆菌毒素注射、电刺激、神经松解、神经移植、神经瘤切除和神经移植、骨折和半脱位的治疗、肌肉挛缩松解和肌腱移植。
