Definition and Diagnosis

In response to bodily stress (e.g., surgery, flu, unusually excessive exercise), the nerves in your neck or arm may become inflamed. The exact cause is unknown. This inflammation is quite painful, which limits use of the arm. As the pain slowly resolves over a few days or weeks, the patient now notices paralysis and numbness in the shoulder and arm. The amount of paralysis varies, with unusually severe cases having complete arm paralysis. Weakness and numbness slowly resolves over time. This may take many months, or even a year or more to occur. Although most people improve, the arm may not return to normal and remain partially paralyzed. Brachial plexitis may involve nerves controlling almost any muscle, however, nerves to the shoulder, scapula, and forearm are more commonly affected. Diagnosis is obtained by history and physical examination, and by excluding all other possible causes. Electrical testing is useful for both diagnosis as well as determining prognosis. Usually a more diffuse inflammatory process is present on electrical testing than is present clinically. This condition may be recurrent and even be inherited (rare).

Treatment Options

During the first few days, pain control is prioritized. Once the acute pain has mostly resolved, gentle and progressive physical therapy is started, which promotes range of motion and subsequent recovery. Although a complete return to normal strength may not occur spontaneously, for some of these patients, progressive resistance training allows them to return to normal function. Surgery is rarely indicated, however, in select cases without any clinical oryuuuuh8u electrical recovery by about six months, neurolysis and/or nerve transfers may be an option. Therefore, all patients should be evaluated early and followed by a physician with expertise in brachial plexitis.