The shoulder is an anatomical unit characterized by the large size and complexity of the structure. It is located on the lower and upper sides of the clavicle. The shoulder originates at the spine and extends to the lower border of the armpit. This structure is constantly exposed to various pathological processes. Among them, plexopathy deserves special attention. What is this disease, what are the prerequisites for the development and species has - the answers to these questions are presented in today's article.
Pathology Description
Plexopathy of the brachial plexus is an inflammatory disease in which damage to the nerve structures occurs. This pathology is quite serious, because it can lead to disability of a person. This concept includes not only the loss of the ability to work. Patients with plexopathy gradually lose their ability to perform basic hand movements. Often they cannot even serve themselves, and therefore require constant care.
It is especially difficult for the patient to adapt to new conditions when the pathological process extends to the arm with which he performs the basic movements. Recovery requires a lot of effort and time. Pain discomfort increases every time you try to raise a limb or take it to the side. The intensity of this symptom increases at night.
In the International Classification of Diseases, you can find a detailed description of what constitutes plexopathy of the brachial plexus. The ICD of the 10th revision considers such pathologies under the code G55.0.
The main causes of inflammation
The brachial plexus consists of the anterior branches of the lower nerves of the neck and the thoracic spinal nerve. From an anatomical point of view, it is in a very vulnerable place. In the immediate vicinity of the shoulder region, many blood vessels pass, and the upper part of the lung is located directly below it.
These and many other factors determine the causes of the disease:
- Injuries and mechanical damage. This could be the result of a car accident or a knife wound. In young children, brachial plexus plexopathy is most often the result of birth injury.
- "Backpack paralysis." The onset of symptoms is caused by prolonged wearing of a bag on one shoulder.
- Scale Syndrome . This is a pathological condition characterized by damage to the vessels and nerves of the costoclavicular space.
- Benign and malignant neoplasms. A classic example is cancer of the apex of the right lung. Growing into the brachial plexus and the dome of the diaphragm, the tumor is manifested by the weakness of the hand and its numbness.
- Various immune disorders (Personage-Turner syndrome).
With plexopathy, it is not always possible to identify any one predisposing factor. In some patients, the disease develops for no apparent reason. In this case, they talk about the idiopathic form of the disease.
First symptoms
The clinical picture of the pathological process is characterized by a change in two stages. The neuralgic phase is accompanied by pains in the hand of varying degrees of intensity. Following her comes paralytic. This phase is characterized by the development of weakness in the hand up to complete immobility.
Plexopathy pain syndrome is wave-like. At first, the patient does not feel any discomfort. Within a few days, he may wake up from unbearable pain. Unpleasant sensations usually intensify with the movement of the arm and head, after a change in body position.
What are the symptoms of brachial plexus plexopathy? The clinical picture is largely dependent on the root cause of the disorder. For example, in staircase syndrome, the disease is accompanied by a feeling of numbness in the neck and back of the neck. Over time, the intensity of the symptoms increases.
With various immune disorders, the manifestations of the disease are slightly different. Against the background of the Personage-Turner syndrome, plexopathy proceeds paroxysmally. First, severe pain in the arm appears, which increases with movements. Then the discomfort subsides, but at the same time there is muscle weakness in the shoulder girdle. The patient can freely move his hand in the wrist and elbow joints, but its rise becomes impossible. Such attacks are repeated at different intervals.
Disease classification
Plexopathy of the brachial plexus can take several forms:
- Paralysis of the deltoid muscle (Erb syndrome), in which the arm cannot be taken away.
- Paralysis of the biceps of the shoulder, accompanied by loss of mobility of the forearm in the elbow joint.
- Paralysis of the supraspinatus and infraspinatus muscle makes rotation of the shoulder impossible. It is about movement when a person is asked to straighten his back and straighten his shoulders.
In especially serious cases, if the pathological process extends to all the nerves of the brachial plexus, complete paralysis of the arm develops. In this case, the diseased limb loses sensitivity.
Diagnostic Methods
If the first symptoms of plexopathy occur, you should seek the help of a doctor. Neurologists are involved in the treatment of this pathology. If a plexopathy of the brachial plexus is suspected, the diagnosis begins with a survey of the patient and a study of his history. Then they move on to instrumental research methods.
The most informative is characterized by electroneuromyography. Using this procedure, the doctor can assess the condition of each nerve originating from the brachial plexus. Additionally, CT, MRI and ultrasound of the affected area are prescribed. These studies allow us to assess the degree of development of the pathological process. Differential diagnosis is carried out with the following diseases: polyneuritis, radicular neuritis, cervical sciatica, shoulder arthritis.
Conservative treatment
At the initial stage of the development of the disease, therapy is carried out on an outpatient basis. Of the drugs, the following medicines are used:
- Analgin-based painkillers (to relieve discomfort).
- Anticholinesterase drugs (with weakness in muscles and paralysis). For example, Proserine or Galantamine.
- Nootropic drugs and vitamin complexes (to improve metabolism in tissues).
Drug therapy is indicated for the acute course of the disease. Physiotherapy is recommended for patients with a diagnosis of chronic brachial plexopathy. Treatment in this case involves the use of mud applications, massage procedures, UHF and electrophoresis.
Surgical intervention
If the development of the disease is provoked by an injury or tumor, surgery is indicated. During the intervention, the surgeon releases the nerve fibers that are “pinched” by the surrounding tissues. Posttraumatic plexopathy of the brachial plexus responds well to treatment if the patient seeks help on time. After the operation, a long recovery period will be required, which is not recommended to be neglected.
Preventive actions
Plexopathy of the brachial plexus after a course of therapy may occur again. To prevent the re-development of the disease, preventive measures should not be neglected.
Doctors recommend swimming. Classes in the pool allow you to maintain the body in good shape, prevent the occurrence of inflammatory processes in the joints. In addition, swimming has a beneficial effect on the emotional mood of a person.
It is also useful to engage in other sports. Adequate physical activity positively affects human health at any age. For example, simple exercise therapy exercises can increase joint mobility and prevent their ossification. Physiotherapy exercises strengthens the immune system, increases the body's resistance to various infectious agents.