Prognostic value of needle electromyography in traumatic brachial plexus injury

Impastato, David M.; Impastato, Katherine A.; Dabestani, Parinaz J.; Ko, Jason H.; Bunnell, Aaron E.

doi:10.1002/mus.26684

Cited by 17 publications

(18 citation statements)

References 11 publications

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“…EMG and NCS are recognized ancillary diagnostic tests for determining the localization and severity of nerve injuries [ 16 ], as well as for monitoring the effectiveness of treatment [ 10 ]. However, due to the need for specific devices and specialized expertise, these techniques have so far not become routine tools in bovine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Use of Electrodiagnostics in the Diagnosis and Follow-Up of Brachial Plexus Syndrome in a Calf

Bolcato

Roccaro

Jacinto

et al. 2022

Veterinary Sciences

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Electrodiagnostic testing by using electromyography (EMG) and nerve conduction studies (NCS) is essential in the evaluation of patients with traumatic brachial plexus injury as it facilitates the localization of the lesion and the prognosis. In this case report, we present a long-term electrodiagnostic follow-up of a 5-day-old female Holstein calf with brachial plexus syndrome. Electrodiagnostic studies were carried out at 2 weeks, 5 weeks, 7 months and 12 months after admission. Initially, EMG confirmed the damage to the brachial plexus, potentially indicating a condition of neurotmesis or axonotmesis. However, motor NCS and the repeated electrodiagnostic follow-up, along with the evolution of the clinical signs, allowed a more favorable diagnosis of axonotmesis to be made. In fact, EMG showed a slow but gradual reduction and finally the disappearance of spontaneous pathological activity, while motor NCS revealed an increase in the amplitude and areas of the compound muscle action potentials. The animal was deemed fully recovered 12 months after admission. To the authors’ knowledge, this is the first report on the use of motor NCS in bovine medicine and it demonstrates that electrodiagnostics represent a useful and practical tool for the evaluation and prognosis of brachial plexus injury cases in cattle.

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Section: Discussionmentioning

confidence: 99%

Use of Electrodiagnostics in the Diagnosis and Follow-Up of Brachial Plexus Syndrome in a Calf

Bolcato

Roccaro

Jacinto

et al. 2022

Veterinary Sciences

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“… 30 Patients should be considered for electrodiagnostic testing between 1 and 3 months after injury to evaluate nerve continuity and deltoid innervation. 31 Recently an electrodiagnostic parameter for the detection of axillary motor nerve injury was determined by comparing a conduction study of the contralateral limb; however, it has not been shown to be a prognostic factor in treatment outcomes. 32 On the other hand, brachial plexus injuries without or with minimal voluntary motor unit potentials at 2–4 months are suggestive of poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

“… 32 On the other hand, brachial plexus injuries without or with minimal voluntary motor unit potentials at 2–4 months are suggestive of poor outcomes. 31 Therefore, the authors recommend electrodiagnostic testing for diagnosis confirmation after 1 month of conservative management followed by repeated electrodiagnostic testing at 2–4 months to project expected outcomes with continued conservative management versus surgical neurotization. If the patient does not show improvement on the second electrodiagnostic testing, most authors would suggest surgical intervention within six months from the date of injury.…”

Section: Discussionmentioning

confidence: 99%

Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review

Wells

Gonzalez

Childs

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Brachial plexus and axillary nerve injuries often result in paralysis of the deltoid muscle. This can be functionally debilitating for patients and have a negative impact on their activities of daily living. In these settings, transferring the branch of the radial nerve innervating the triceps to the axillary nerve is a viable treatment option. Additional nerve transfers may be warranted. This study sought to determine the efficacy of nerve transfer procedures in the setting of brachial plexus and axillary nerve injuries and factors affecting clinical outcomes. Methods: The U.S. National Library of Medicine’s website “PubMed” was queried for “radial to axillary nerve transfer” and “brachial plexus nerve transfer.” An initial review by two authors was performed to identify relevant articles followed by a third author validation utilizing inclusion and exclusion criteria. Individual patient outcomes were recorded and pooled for final analysis. Results: Of the 80 patients, 66 (82.5%) had clinical improvement after surgical nerve transfer procedures. Significant difference in clinical improvement following nerve transfer procedures was correlated with patient age, mechanism of injury, brachial plexus vs isolated axillary nerve injuries, multiple nerve transfers vs single nerve transfers, and surgery within the first 7 months of injury. The branch of the radial nerve supplying the triceps long head showed improved clinical results compared with the branch of the radial nerve supplying the triceps medial head and anconeus. Conclusion: Nerve transfers have been shown to be effective in restoring shoulder abduction in both isolated axillary nerve injuries and brachial plexus injuries.

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“…This injury causes hyper abduction of the shoulder and widening of the humeral angle of the scapula affecting the C8 and T1 nerve roots, preventing high-speed traction lead to avulsion of C5, C6, C7, C8, and T1. This mechanism refers primarily to nerve root avulsion lesions, occurs in 70-80% of the motorcycle accidents [27], [28] [29] (Figure 2).…”

Section: Definition and Pathophysiologymentioning

confidence: 99%

Brachial Plexus Injury: Recent Diagnosis and Management

Sumarwoto

Suroto

Mahyudin³

et al. 2021

Open Access Maced J Med Sci

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Brachial plexus injury is known to be one of the most serious upper limb injuries, causes paralysis of the upper limbs and changes in activity of daily living, with the consequence disruption of activity of daily living, socio-economic problems, depression, and hopelessness. Management must be done properly. The evaluation and examination consist of detailed anamnesis on chronological events, complete physical examination, imaging studies, and electrophysiology study. Management can be done nonsurgically and surgically. Knowledge of the history of injury, timing of surgery, priority in restoring function, and managing patient expectations are important concepts in treating patient with brachial plexus injury. Timing is a very important thing. The results of these interventions vary depending on several parameters. Recognizing the basic principles of managing brachial plexus injuries is indispensable for all clinicians who treat these injuries.

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Prognostic value of needle electromyography in traumatic brachial plexus injury

Cited by 17 publications

References 11 publications

Use of Electrodiagnostics in the Diagnosis and Follow-Up of Brachial Plexus Syndrome in a Calf

Use of Electrodiagnostics in the Diagnosis and Follow-Up of Brachial Plexus Syndrome in a Calf

Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review

Brachial Plexus Injury: Recent Diagnosis and Management

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