Brachial plexus pathology

Question 1

How will pathology affecting the brachial plexus present?

Answer 1

• LMN signs affecting all or part of the forelimb

Question 2

Brachial plexus neoplasia - prevalence

Answer 2

• not uncommon in practice but can be difficult to diagnose in the early stages of the dz

Question 3

Brachial plexus neoplasia - presentation

Answer 3

• progressive lameness of a forelimb which doesn’t respond to analgesia
• progresses with increasing muscle atrophy and weakness with neurological deficits
• often painful on deep palpation of the plexus and in advanced cases a mass lesion can sometimes be felt

Question 4

Brachial plexus neoplasia - diagnosis

Answer 4

• advanced imaging

Question 5

Brachial plexus neoplasia - tx

Answer 5

• amputation of forelimb if adequate local margins can be achieved
• usually benign neoplasm

Question 6

Brachial plexus avulsion - presentation

Answer 6

• sudden onset, non-progressive, paresis/paralysis of all or some of the muscles in the forelimb following trauma

Question 7

Brachial plexus avulsion - diagnosis

Answer 7

• extent of nerves affected can be mapped by careful examination or electrophysiology
• advanced imaging doesn’t provide definitive diagnosis

Question 8

Brachial plexus avulsion - tx & prognosis

Answer 8

• tx conservative & supportive
• active physio to prevent contractures of limb
• prognosis for return of function difficult to determine
• ultimate return of function may take at least 3 months
• if painful or self-trauma may need to consider limb amputation