The shoulder is an anatomical unit characterized by large size and complex structure. It is located on the lower and upper sides of the clavicle. The shoulder originates at the spine and continues 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 prerequisites for development and types it has - the answers to these questions are presented in today's article.
Description of pathology
Plexopathy of the brachial plexus is an inflammatory disease in which nerve structures are damaged. This pathology is quite serious, since it can lead to disability of a person. This concept includes not only the loss of the opportunity to work. Patients with plexopathy gradually lose the ability to perform elementary hand movements. Often they cannot even take care of themselves, so they require constant care.
It is especially difficult for the patientadapt to new conditions, when the pathological process extends to the hand with which he performs the main movements. Recovery takes a lot of time and effort. Pain discomfort increases every time you try to lift 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. ICD 10th revision considers such pathologies under the code G55.0.
Main causes of inflammation
The brachial plexus consists of the anterior branches of the inferior nerves of the neck and the thoracic spinal nerve. From an anatomical point of view, it is in a very vulnerable place. There are many blood vessels in the immediate vicinity of the shoulder area, and the upper part of the lung is located directly below it.
These and many other factors determine the causes of the disease:
- Injury and mechanical damage. It could be the result of a car accident or a stab wound. In young children, brachial plexopathy is most often the result of birth trauma.
- "Backpack Paralysis". The appearance of symptoms of the disease is due to the long-term wearing of the bag on one shoulder.
- Syndrome of the scalene muscle. This is a pathological condition characterized by damage to the vessels and nerves of the costoclavicular gap.
- Benign and malignant neoplasms. A classic example is cancer of the apex of the right lung. Growing into the shoulderplexus and dome of the diaphragm, the swelling is manifested by the weakness of the hand and its numbness.
- Various immune disorders (Parsonage-Turner syndrome).
It is not always possible to identify any one predisposing factor in plexopathy. In some patients, the disease develops for no apparent reason. In this case, they speak of an idiopathic form of the disease.
First symptoms
The clinical picture of the pathological process is characterized by a change of two stages. The neuralgic phase is accompanied by pain in the arm of varying degrees of intensity. Paralytic comes after her. This phase is characterized by the development of weakness in the hand up to complete immobility.
Pain in plexopathy is undulating. At first, the patient does not feel discomfort at all. After a few days, he can wake up from unbearable pain. Unpleasant sensations usually increase with movement of the arm and head, after a change in body position.
What other symptoms does brachial plexus plexopathy have? The clinical picture largely depends on the underlying cause of the disorder. For example, with the syndrome of the scalene muscle, the disease is accompanied by a feeling of numbness in the back of the head and back of the neck. Symptoms increase in intensity over time.
With various immune disorders, the manifestations of the disease are slightly different. Against the background of the Personage-Turner syndrome, plexopathy proceeds paroxysmal. First, there is severe pain in the arm, which increases with movement. 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 lifting 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 moved to the side.
- Paralysis of the biceps brachii, accompanied by loss of mobility of the forearm in the elbow joint.
- Supraspinatus and infraspinatus paralysis makes rotation of the shoulder impossible. This is a movement where the person is asked to straighten their back and straighten their 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
When the first symptoms of plexopathy occur, seek medical attention. Neurologists are involved in the treatment of this pathology. If a disease of the brachial plexus plexopathy is suspected, the diagnosis begins with a questioning of the patient and a study of his anamnesis. Then they move on to instrumental research methods.
Electroneuromyography is the most informative. With this procedure, the doctor can assess the condition of each nerve originating from the brachial plexus. Additionally, CT, MRI and ultrasound are prescribedthe affected area. 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, arthritis of the shoulder joint.
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 medications are used:
- Painkillers based on analgin (to relieve discomfort).
- Anticholinesterase agents (for muscle weakness and paralysis). For example, Prozerin or Galantamine.
- Nootropic drugs and vitamin complexes (to improve tissue metabolism).
Drug therapy is indicated in 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 treatments, UHF and electrophoresis.
Surgery
If the development of the disease is provoked by an injury or tumor, an operation is indicated. During the intervention, the surgeon releases the nerve fibers "clamped" by the surrounding tissues. Post-traumatic plexopathy of the brachial plexus responds well to treatment if the patient seeks help in time. After the operation, a long recovery period will be required, which is not recommended to be neglected.
Prevention measures
Plexopathy of the brachial plexus may recur after a course of therapy. To prevent the recurrence of the disease, preventive measures should not be neglected.
Doctors recommend swimming. Classes in the pool allow you to keep 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 good to do other sports. Adequate physical activity has a positive effect on human he alth at any age. For example, simple physical therapy exercises can increase joint mobility and prevent their ossification. Therapeutic exercise strengthens the immune system, increases the body's resistance to various infectious agents.
