Diseases of the brachial plexus and the lumbosacral cause a painful, mixed sensorimotor disorder of the corresponding limb.
(See also summary of disorders of the peripheral nervous system.)
Diseases of the brachial plexus and the lumbosacral cause a painful, mixed sensorimotor disorder of the corresponding limb. (See also summary of disorders of the peripheral nervous system.) Because are intertwined several nerve roots within a plexus (plexus), the symptom pattern does not match the Innervationsschema a single root or a nerve. Disorders of the rostral brachial plexus affect the shoulders, disorders of the caudal brachial plexus hands and disorders of the lumbosacral plexus legs. Plexus Plexuserkrankungen (plexopathies) are usually the compression or trauma: In newborns, pulling the arm in adults, mostly trauma (brachial at Plexus typically a fall that stretched his neck against the shoulder) or the invasion by a metastatic tumor (at Plexus brachial typically breast or lung carcinoma and in the lumbosacral plexus intestinal or genitourinary tumors). In patients receiving anticoagulants, a hematoma can compress the lumbosacral plexus. Neurofibromatosis occasionally befalls a plexus. Other causes may radiation-induced fibrosis (z. B. after radiotherapy because of breast cancer) and his diabetes. An acute neuritis brachial (neuralgic shoulder, Parsonage-Turner syndrome) occurs primarily in men and typically in young adults, but it can also occur at any age. The cause is unknown, but viral and immunological inflammatory processes are suspected. Symptoms and signs The symptoms of diseases of the plexus include limb pain and motor or sensory deficits, which are not due to a single nerve root or peripheral innervation. In acute neuritis brachial heavy supraclavicular pain, weakness and weakened reflexes occur with only discrete sensory deficits in the innervation of the brachial plexus. When the pain subsides, paresis and a weakening of the reflexes developed normally. A severe paresis develops within 3-10 days, it typically forms during the next few months back. The muscles most commonly affected are the serratus anterior muscle (which pulls the scapula anteriorly and the rotation of the shoulder easier), other muscles are innervated by the upper part of the brachial plexus, and muscles with innervation by the anterior interosseous nerve (in forearm – the patient may be unable to form ? thumb and index finger). Diagnosis Electromyography and nerve conduction studies of a rule MRI or CT of the corresponding plexus Diagnosis of Plexuserkrankung is assumed based on clinical findings. Electromyography and nerve conduction studies of should be made to clarify the anatomical distribution (incl. Possible nerve root involvement). MRI or CT of the corresponding plexus and the adjacent vertebral column are carried out to determine abnormalities such as tumors and hematomas. An MRI or CT is indicated with the exception of typical cases of neuritis brachial, with all non-traumatic plexopathies. Treatment Treatment is causal aligned. Although they are often prescribed corticosteroids have no proven benefit. Surgical intervention may be indicated in injuries, hematomas and benign or metastatic tumors. The metastases should also be treated with radiation, chemotherapy or both. Patients with diabetic plexopathy can benefit from blood glucose monitoring. Conclusion plexopathies are usually caused by compression or trauma. Consider brachial acute neuritis in patients with severe supraclavicular pain and subsequent weakness and hyporeflexia that occur within a few days and go back for months. Assume a plexopathy if the pain or peripheral neurological deficits do not match the innervation of a nerve root or peripheral nerves. Perform an electromyography and MRI or CT in most cases. Treat the cause.