Brachial Plexus Injury (BPI)

To find patient care programs and faculty treating brachial plexus injury at Kennedy Krieger Institute, please see the right-hand column below. Additional helpful information, including definitions, symptoms, Institute press releases, Potential magazine articles, and other resources outside the Institute, have also been provided for readers on this page.

Brachial Plexus Injury Overview:

The brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm, elbow, wrist, hand and fingers that allow movement and sensation. Damage to the nerves from inflammation, tumors, stretching, tearing or other trauma is considered a brachial plexus injury. Most pediatric BPIs occur during the birthing process. Other causes of BPIs include motor vehicle accidents, sports injuries and gunshot wounds.

The most severe type of injury is avulsion. Avulsion is caused when the nerve root is pulled out from the spinal cord. If only part of the nerve is pulled, an incomplete form of avulsion can occur. If a nerve is stretched, there can be a transient disruption of the insulation surrounding the nerve fibers. This form of injury (Neuropraxia) recovers over hours to days. In a more severe stretch injury, there is disruption (axonotemsis) of the internal electricity carry fibers (axons). These fibers have to regenerate or grow back down to their target muscles or area of skin. This process of re-growth occurs at approximately one inch per month. In more severe stretch injuries there can be disruption of the internal nerve environment that then scars and prevents much of the re-growth of fibers. This leads to formation of a neuroma, or tangle of nerve fibers. There is little recovery of function and management should include surgical repair of the nerves. A very severe stretch injury can cause the nerve to split and a complete rupture is present. There is no hope of recovery without surgical repair.

Examples, Subsets and Synonyms for Brachial Plexus Injury:

  • Brachial Plexus Palsy
  • "Burners" or "Stingers" (usually associated with sports-related brachial plexus injuries)
  • Erb's Palsy (upper trunk injury)
  • Erb-Duchenne Palsy
  • Horner's Syndrome (when facial nerves are also affected)
  • Klumpke's Palsy (lower trunk injury)\Obstetrical Brachial Plexus Injury
  • Parsonage-Turner Syndrome (inflammation of the brachial plexus)