Electrodiagnostic Evaluation Of Brachial Plexopathies

Brachial Plexus injuries, or brachial plexopathies, are considered among the most devastating of neurological injuries. Numerous mechanisms of injury leading to these afflictions exist, including traction injuries (falls, sports injuries, obstetric), compression injuries (crutches, pack straps, surgical malpositioning), lacerations from penetrating trauma, ischemia, and neoplastic disease. Since most nerves of the brachial plexus are mixed nerves containing both motor and sensory components, patients usually present with some combination of weakness and sensory deficit in the upper extremity, within the distribution of the injured root, trunk, cord, or branch of the brachial plexus. Thorough history and physical examination are the first steps in evaluation of brachial plexopathies and provide valuable clues as to the anatomical location of the injury, as well as the extent of the injury. Based on a provisional diagnosis derived from the physical exam, radiographic imaging and electrodiagnostic studies are then used to further pinpoint the location and severity of injury. Here, we focus on the use of electromyography and nerve conduction studies in the diagnosis and prognostication of brachial plexopathies.