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Standard neurophysiological studies and motor evoked potentials in evaluation of traumatic brachial plexus injuries – A brief review of the literature
Affiliations- Department of Pathophysiology of Locomotor Organs, Poznań University of Medical Sciences, Poland
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Abstract
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.
MethodsThe 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.
ConclusionsThe 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
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.
MethodsThe 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.
ConclusionsThe 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.
Keywords
Brachial plexus, Traumatic injury, Clinical neurophysiology, Motor evoked potentials
About this articleTitle
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
Article type
Review Article
Pages
549-554
Published online
2018-05-14
Page views
438
Article views/downloads
727
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
