open access

Vol 52, No 5 (2018)
Review article
Submitted: 2018-02-09
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Standard neurophysiological studies and motor evoked potentials in evaluation of traumatic brachial plexus injuries – A brief review of the literature

Agnieszka Wiertel-Krawczuk, Juliusz Huber
DOI: 10.1016/j.pjnns.2018.05.004
·
Neurol Neurochir Pol 2018;52(5):549-554.

open access

Vol 52, No 5 (2018)
Review article
Submitted: 2018-02-09

Abstract

Purpose

Traumatic damage to the brachial plexus is associated with temporary or permanent motor and sensory dysfunction of the upper extremity. It may lead to the severe disability of the patient, often excluded from the daily life activity. The pathomechanism of brachial plexus injury usually results from damage detected in structures taking origin in the rupture, stretching or cervical roots avulsion from the spinal cord. Often the complexity of traumatic brachial plexus injury requires a multidisciplinary diagnostic process including clinical evaluation supplemented with clinical neurophysiology methods assessing the functional state of its structures. Their presentation is the primary goal of this paper.

Methods

The basis for the diagnosis of brachial plexus function is a clinical examination and neurophysiology studies: electroneurography (ENG), needle electromyography (EMG), somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) assessing the function of individual brachial plexus elements.

Conclusions

The ENG and EMG studies clarify the level of brachial plexus damage, its type and severity, mainly using the Seddon clinical classification. In contrast to F-wave studies, the use of the MEPs in the evaluation of traumatic brachial plexus injury provides valuable information about the function of its proximal part. MEPs study may be an additional diagnostic in confirming the location and extent of the lesion, considering the pathomechanism of the damage. Clinical neurophysiology studies are the basis for determining the appropriate therapeutic program, including choice of conservative or reconstructive surgery which results are verified in prospective studies.

Abstract

Purpose

Traumatic damage to the brachial plexus is associated with temporary or permanent motor and sensory dysfunction of the upper extremity. It may lead to the severe disability of the patient, often excluded from the daily life activity. The pathomechanism of brachial plexus injury usually results from damage detected in structures taking origin in the rupture, stretching or cervical roots avulsion from the spinal cord. Often the complexity of traumatic brachial plexus injury requires a multidisciplinary diagnostic process including clinical evaluation supplemented with clinical neurophysiology methods assessing the functional state of its structures. Their presentation is the primary goal of this paper.

Methods

The basis for the diagnosis of brachial plexus function is a clinical examination and neurophysiology studies: electroneurography (ENG), needle electromyography (EMG), somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) assessing the function of individual brachial plexus elements.

Conclusions

The ENG and EMG studies clarify the level of brachial plexus damage, its type and severity, mainly using the Seddon clinical classification. In contrast to F-wave studies, the use of the MEPs in the evaluation of traumatic brachial plexus injury provides valuable information about the function of its proximal part. MEPs study may be an additional diagnostic in confirming the location and extent of the lesion, considering the pathomechanism of the damage. Clinical neurophysiology studies are the basis for determining the appropriate therapeutic program, including choice of conservative or reconstructive surgery which results are verified in prospective studies.

Get Citation

Keywords

Brachial plexus, Traumatic injury, Clinical neurophysiology, Motor evoked potentials

About this article
Title

Standard neurophysiological studies and motor evoked potentials in evaluation of traumatic brachial plexus injuries – A brief review of the literature

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 52, No 5 (2018)

Pages

549-554

DOI

10.1016/j.pjnns.2018.05.004

Bibliographic record

Neurol Neurochir Pol 2018;52(5):549-554.

Keywords

Brachial plexus
Traumatic injury
Clinical neurophysiology
Motor evoked potentials

Authors

Agnieszka Wiertel-Krawczuk
Juliusz Huber

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