No abstract available.
Brachial Plexus Neuropathies*

Segmental zoster paresis is characterized by skin rash, sensory change and motor weakness in the myotome that corresponds to the dermatome of the rash. Herpes zoster induced pure motor paresis is a rare complication of herpes zoster without sensory involvement in brachial plexopathy. We present a case of segmental paresis, which involved motor nerve without sensory nerve involvement electrophysiologically.
Brachial Plexus Neuropathies ; Exanthema ; Herpes Zoster ; Paresis

No abstract available.
Brachial Plexus Neuropathies* ; Lipomatosis, Multiple Symmetrical*

Complex regional pain syndrome secondary to brachial plexus injury is often severe, debilitating and difficult to manage. Percuteneous radiofrequency sympathectomy is a relatively new technique, which has shown promising results in various chronic pain disorders. We present four consecutive patients with complex regional pain syndrome secondary to brachial plexus injury for more than 6 months duration, who had undergone percutaneous T2 and T3 radiofrequency sympathectomy after a diagnostic block. All four patients experienced minimal pain relief with conservative treatment and stellate ganglion blockade. An acceptable 6 month pain relief was achieved in all 4 patients where pain score remained less than 50% than that of initial score and all oral analgesics were able to be tapered down. There were no complications attributed to this procedure were reported. From this case series, percutaneous T2 and T3 radiofrequency sympathectomy might play a significant role in multi-modal approach of CRPS management.
Analgesics ; Brachial Plexus ; Brachial Plexus Neuropathies ; Chronic Pain ; Humans ; Stellate Ganglion ; Sympathectomy

Brachial Plexus ; anatomy & histology ; Brachial Plexus Neuropathies ; therapy ; Humans ; Orthopedics ; education ; Teaching

Adult ; Brachial Plexus ; injuries ; Brachial Plexus Neuropathies ; rehabilitation ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Brachial plexus injury is a potential complication of a brachial plexus block or vessel puncture. It results from direct needle trauma, neurotoxicity of injection agents and hematoma formation. The neurological presentation may range from minor transient pain to severe sensory disturbance or motor loss with poor recovery. The management includes conservative treatment and surgical exploration. Especially if a hematoma forms, it should be removed promptly. Comprehensive knowledge of anatomy and adept skills are crucial to avoid nerve injuries. Whenever possible, the patient should not be heavily sedated and should be encouraged to immediately inform the doctor of any experience of numbness/paresthesia during the nerve block or vessel puncture.
Brachial Plexus Neuropathies ; Brachial Plexus* ; Hematoma ; Humans ; Needles ; Nerve Block* ; Punctures* ; Subclavian Vein

Brachial Plexus ; surgery ; Brachial Plexus Neuropathies ; Humans ; Nerve Transfer ; methods ; Spinal Nerve Roots ; surgery

OBJECTIVE: This study aims at evaluating the usefulness of the electrodiagnostic study (EDx) and the magnetic resonance imaging (MRI), which are performed before surgical operation of brachial plexus injury. METHOD: We reviewed 57 cases of brachial plexopathy diagnosed with surgical findings. EDx and MRI were performed to the patients before surgery. Based upon intraoperative findings, we evaluated the occurrence of preganglionic root injury and subsequently each injured spinal root level. RESULTS: EDx and MRI for preganglionic root injuries showed 92.1% and 78.9% of diagnostic sensitivity and 63.2% and 42.9% of diagnostic specificity, respectively. The followings were about each injured spinal root level. EDx showed that the sensitivities of C5, C6, C7, C8, T1 were 91.4%, 91.4%, 92.6%, 96%, 95.8%, and their specificities were 59.1%, 59.1%, 56.7%, 68.8%, 66.7%. MRI showed that the sensitivities were 47.4%, 57.9%, 58.3%, 75%, 66.7%, and their specificities were 57.1%, 71.4%, 78.6%, 85.7%, 85.7%. CONCLUSION: As for preganglionic brachial plexopathy, EDx was more useful than MRI to diagnose preganglionic root injury and determine the level of injured spinal root.
Brachial Plexus ; Brachial Plexus Neuropathies* ; Humans ; Magnetic Resonance Imaging* ; Sensitivity and Specificity ; Spinal Nerve Roots

Our previous investigation suggested that faster seventh cervical nerve (C7) regeneration occurs in patients with cerebral injury undergoing contralateral C7 transfer. This finding needed further verification, and the mechanism remained largely unknown. Here, Tinel's test revealed faster C7 regeneration in patients with cerebral injury, which was further confirmed in mice by electrophysiological recordings and histological analysis. Furthermore, we identified an altered systemic inflammatory response that led to the transformation of macrophage polarization as a mechanism underlying the increased nerve regeneration in patients with cerebral injury. In mice, we showed that, as a contributing factor, serum amyloid protein A1 (SAA1) promoted C7 regeneration and interfered with macrophage polarization in vivo. Our results indicate that altered inflammation promotes the regenerative capacity of the C7 nerve by altering macrophage behavior. SAA1 may be a therapeutic target to improve the recovery of injured peripheral nerves.
Animals ; Brachial Plexus ; Brachial Plexus Neuropathies/surgery* ; Humans ; Mice ; Nerve Transfer ; Peripheral Nerves ; Spinal Nerves