Non-traumatic brachial plexopathies, clinical, radiological and neurophysiological findings from a tertiary centre

Abstract 

Objective

To establish the clinical characteristics, aetiology, neuro-physiological characteristics, imaging findings and other investigations in a cohort of patients with non-traumatic brachial plexopathy (BP).

Methods

A 3-year retrospective study of patients with non-traumatic BP identified by electromyography (EMG) and nerve conduction studies (NCS). Clinical information was retrieved from patients’ medical charts.

Results

Twenty-five patients were identified. Causes of BP included neuralgic amyotrophy (NA) (48%), neoplastic (16%), radiation (8%), post infectious (12%), obstetric (4%), rucksack injury (4%), thoracic outlet syndrome (4%) and iatrogenic (4%).

Patients with NA presented acutely in 50%. The onset was subacute in all others. Outcome was better for patients with NA. All patients with neoplastic disease had a previous history of cancer.

MRI was abnormal in 3/16 patients (18.8%).

PET scanning diagnosed metastatic plexopathy in two cases.

Conclusions

NA was the most common cause of BP in our cohort and was associated with a more favourable outcome.

The authors note potentially discriminating clinical characteristics in our population that aid in the assessment of patients with brachial plexopathies.

We advise NCS and EMG be performed in all patients with suspected plexopathy. Imaging studies are useful in selected patients.

Keywords: Brachial plexus, Plexopathy, Non-trauma, Neuralgic amyotrophy, Radiation plexopathy, Neurophysiology, MRI