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• W3181567482 abstract "The brachial plexus has more than 166,000 interconnected axons and it́s a very vulnerable structure. Imaging studies do not provide functional information about the plexus and routine electrodiagnostic studies are usually incomplete. The anatomy and pathophysiology of the lesions must be known to improve the treatment outcomes. The clinical and electrodiagnostic evaluations must be extensive but oriented. A root injury must be suspected after traction injuries, proximal wounds, in the presence of impairment of muscles innervated directly from roots like anterior serratus, rhomboids, diaphragm and in the presence of dysfunction of sympathetic preganglionic fibers from C8-T1. A trunk injury must be suspected after supraclavicular or retro-clavicular injuries, in the presence of suprascapular nerve involvement (upper trunk) or selective impairment of median or radial nerves. No branches arise from middle or lower trunks and isolated middle trunk lesions are very rare. An injury at the cord level must be suspected after infra-clavicular injuries, in presence of involvement of the medial brachial and antebrachial cutaneous nerves, involvement of latissimus dorsi, pectoralis and median nerve selective compromise. In motor nerve conduction studies (MNCS), the distal amplitude represents an estimate of the number of viable axons. For uncommon MNCS the side to side amplitude comparison is the best indicator of nerve damage. No motor NCS is available for C7. Some MNCS are helpful to localize (e.g.: radial over EIP, suprascapular). The sensory nerve conduction studies (SNCS) are helpful to differentiate a pre vs postganglionic lesion (after > 10 days). Detailed sensory studies help to define injured structures even better than motor conductions. No sensory NCS is available for C5. The needle EMG studies are useful to detect mild axonal loss. There is no correlation between number of Fibs/PSWs and severity of the axonal loss. The recruitment reduced in conduction block. Localizing muscles must be evaluated and the muscle domains must be well known. The utility of late responses like F wave and H reflex is limited in this context. Somatosensory Evoked Potentials are useful to determine continuity from the peripheral to the central nervous system." @default.
• W3181567482 created "2021-07-19" @default.
• W3181567482 creator A5042882956 @default.
• W3181567482 date "2021-08-01" @default.
• W3181567482 modified "2023-09-25" @default.
• W3181567482 title "WS3.2. Electrophysiological Assessment of Brachial Plexopathies" @default.
• W3181567482 doi "https://doi.org/10.1016/j.clinph.2021.02.082" @default.
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