What Is Brachial Plexus Palsy?

Medically Reviewed by Dany Paul Baby, MD on April 27, 2022
5 min read

Brachial palsy is weakness or paralysis of the arm due to brachial plexus injury. The brachial plexus is a network of nerves near your neck that connect your spinal cord to your arms. These nerves help your shoulder, arm, hand, and fingers move. If the brachial plexus gets injured, it causes weakness and loss of motion in your arm.

The brachial plexus is a complex network of nerves near your neck. It extends from the neck under your collar bone into your arms. It gives rise to all the nerves from your shoulders to your fingers. These nerves connect the spinal cord to your arms. They control the movement of muscles in the shoulder, elbow, wrist, hand, and fingers. They are also responsible for feeling or sensation in your arms.

You can get brachial plexus nerve damage due to an injury. It can affect the nerves that pass from the neck to the arm. If these nerves get stretched, compressed, or torn due to injury, they can’t pass on signals from the brain to your arm muscles. This causes weakness and loss of movement in your arm, which is called brachial palsy. Palsy means paralysis or the inability to move muscles in the affected area.

Brachial plexus injuries may heal over time. But some may cause long-term disability if left untreated.

Brachial palsy can occur in children and adults.

Brachial plexus palsy in children. Brachial plexus nerve damage can happen during childbirth. It can happen during a complicated delivery due to extended labor, a large baby, and breech presentation, where the baby’s feet or buttocks leave the womb first.

During a complicated delivery, the child’s shoulder may get stuck in the mother’s womb. When the baby is being pulled out of the birth canal, they can get a stretch injury in the shoulder, neck, or arm. A stretch injury is when the brachial plexus nerves get stretched. This can lead to brachial palsy.

When the baby’s upper nerves get stretched, their shoulder may not move, but they can move their fingers. This is known as Erb’s palsy. If upper and lower nerves get stretched, it can affect the entire arm. This is called global or total brachial plexus palsy.

In older children, brachial plexus palsy can also occur because of a stretch injury if the neck or shoulder gets stretched.

Brachial plexus palsy in adults. Brachial plexus palsy in adults usually occurs due to injury or trauma to the neck and shoulder. Typically, a stretch injury in the neck or shoulder causes brachial plexus nerve damage and loss of motion.

Based on the type of brachial plexus nerve damage, you may notice symptoms in the shoulder, elbow, hand, or fingers. Brachial plexus palsy symptoms include:

  • Loss of feeling in the arm
  • Loss of muscle control
  • Loss of motion or limited range of motion
  • Muscle weakness or limpness in one arm
  • Pain and numbness in the arm
  • Partial or total paralysis of the arm

In children, you may notice the arm turning inward or the wrist and hand curling down. Their elbow may be bent because of stiffness in the joint. They may even have trouble moving or controlling their shoulder, arm, wrist, or hand. Some may feel pain or numbness in the arm.

In some children, the arm with brachial plexus nerve damage may look smaller than the other arm. Nerves affect growth and development. So, the affected arm may grow at a slower pace and become noticeable as the child grows.

If left untreated, brachial plexus palsy can lead to permanent weakness or disability. You’ll need medical care if you have brachial plexus palsy symptoms. Visit your doctor if you notice additional symptoms like:

  • Weakness or numbness in your arm or hand
  • Burning or stinging in the arm
  • Neck pain
  • Symptoms in both arms

Doctors diagnose brachial palsy through a physical exam. They also check for muscle weakness in the arm. They may use electromyography to measure the electrical activity of muscles. They may also use imaging tests like an x-ray, ultrasound, CT scan, or MRI.

Apart from these tests, doctors may do a nerve conduction study. This test measures how fast an electrical signal passes through your nerve. It can help detect nerve damage.

In children. Most children with brachial plexus palsy recover over time. If it doesn’t resolve within 1 month, it can lead to long-term disability. So, it’s best to seek treatment immediately. 

Brachial plexus palsy treatment includes occupational and physical therapy. They help reduce stiffness caused by the injury. Children may need to wear splints to keep the arm in one position and help the nerves recover.

Some may require surgery including neurosurgery, hand surgery, and orthopedic surgery along with medicines and rehabilitation.

In adults. A combination of therapy and surgery is used for brachial plexus palsy treatment in adults. Occupational therapy, neurosurgery, reconstructive surgery, and medication are used depending on the severity.  Doctors use electromyography to check the recovery of weakened muscles. You may also have to visit the doctor for frequent follow-ups for better recovery.

Brachial plexus palsy treatment outcomes depend on the severity of the condition and how soon the treatment was given. Children with brachial plexus palsy may continue to feel weakness in their arms. Nerves take time to heal. So, it may take about 2 years for total recovery. Some children recover on their own, but others may have to go through surgeries based on their condition.

Brachial plexus nerve damage can’t be prevented. But if you have brachial plexus palsy, immediate treatment can help you heal without any long-term complications. If left untreated, complications can include:

  • Stiff joints
  • Chronic pain
  • Numbness in the arm
  • Muscle damage or atrophy
  • Permanent disability, including muscle weakness and paralysis

If you have any brachial plexus palsy symptoms, contact your doctor for diagnosis and treatment as soon as you can. Early treatment can help prevent complications and aid in quick recovery.