Posttraumatic Respiratory-Biceps Brachii Synkinesis

Idiopathic respiratory synkinesis: A case series

“…It is worth noting that both of our patients had normal physical examination, imaging study, and EMG study results. Respiratory synkinesis has often been associated with other neuromuscular findings such as weakness, atrophy, hyporeflexia, Horner syndrome, and EMG abnormalities, but these were absent in our patients.…”

Motor Recovery and The Breathing Arm After Brachial Plexus Surgical Repairs, Including Re-Implantation of Avulsed Spinal Roots Into The Spinal Cord

“…The muscle unit potentials (MUPs) associated with respiration have been reported to be present as early as 4 to 8 months after trauma or surgery, and then, often, to gradually wane (Takahashi, 1983), although the involuntary muscle contraction of the biceps still occurred when the patient sneezed or coughed (Nagano et al, 1989). In other studies, particularly in patients with obstetric brachial plexus palsy, the muscle contractions associated with respiration could still be observed 20 years later (Robinson, 1951; Schwarz, 1965). In our study, this phenomenon was observed many years following injury.…”

“…The breathing arm phenomenon was described by Erb more than a hundred years ago (Swift, 1994) and by others more recently (Carlstedt et al, 2004; Robinson, 1951; Schwarz, 1965; Swift, 1994). Swift reported that needle EMG examination of the limbs muscles showed the characteristic features of the MUPs pattern of the diaphragm (Swift, 1994).…”

“…Fibres to the phrenic nerve sometimes travel with the C5 nerve before joining the phrenic nerve. Injuries to the upper trunk and consequent regeneration could, thus, lead to synkinesis between the muscles of the limb and diaphragm (Schwarz, 1965; Swift, 1994). It would be reasonable to assume that the source of the breathing arm in patients with lower plexus injury repaired by intercostal nerve transfers is through a similar mechanism.…”

Brachial and lumbosacral plexopathies: A review

“…In very severe brachial plexopathies associated with severe loss of axons, voluntary MUPs may be absent or, if there is early, minimal reinnervation, “nascent” MUPs may be recorded ( Borenstein and Desmedt, 1980 ). In some cases of severe, longstanding upper trunk brachial plexopathies, aberrant reinnervation by the phrenic nerve or upper cervical roots to proximal upper extremity muscles may produce a respiratory pattern of firing (sometimes referred to as a “breathing arm”) ( Swift et al, 1980 , Friedenberg and Hermann, 2004 , Schwarz, 1965 ).…”