brachial plexus pain
Introduction
Introduction to brachial plexus neuralgia Brachial plexus neuralgia refers to a disease in which the various parts of the brachial plexus, which are composed of the anterior branch of the nerve from the neck 5 to the chest 1, are damaged, causing pain within the range of their control. Brachial plexus neuralgia can be divided into primary and secondary types, the latter are more common. The cause of primary brachial plexus neuralgia is unknown. It may be an allergic disease. Occasionally, familial cases are seen in mild trauma, injection, vaccination, mild systemic infection, and secondary brachial plexus neuralgia. , that is, nerve root compression (cervical spondylosis, disc herniation, tuberculosis, tumor, fracture, dislocation, cervical spinal cord tumor and arachnoiditis, etc.) and nerve trunk compression chest outlet syndrome. basic knowledge The proportion of sickness: 0.2% Susceptible people: no specific population Mode of infection: non-infectious Complications: cervical spondylosis
Cause
Causes of brachial plexus neuralgia
Brachial plexus neuralgia can be divided into primary and secondary types. The latter is more common. The cause of primary brachial plexus neuralgia is unknown. It may be an allergic disease. Occasionally, familial cases are seen in mild trauma, injection. Vaccination, mild systemic infection, secondary brachial plexus pain, brachial plexus adjacent to lesion compression, ie nerve root compression (cervical spondylosis, disc herniation, tuberculosis, tumor, fracture, dislocation, cervical spinal cord tumor and arachnoiditis, etc. ) and nerve trunk compression (thoracic outlet syndrome, cervical rib or neck tumor, axillary lymph node enlargement (metastatic cancer), clavicular fracture, lung sulcus tumor, according to its lesion site can be divided into root brachial plexus neuralgia And dry brachial plexus neuralgia, root brachial plexus neuralgia is caused by various cervical cervical lesions, cervical spinal cord tumors, epidural metastatic cancer, etc. The cause of dry brachial plexus neuralgia is cervical and thoracic exit zone syndrome. Brachial plexus neuritis, neck tumor, trauma, tuberculosis, lung tip tumor, etc.
Prevention
Brachial plexus neuralgia prevention
The limb should be properly rested to reduce the activity of the limb, the forearm flexed and slinged to the chest.
Complication
Brachial plexus pain complications Complications cervical spondylosis
There may be complications of structural deformity in the neck and chest exit area, secondary brachial plexus neuralgia may be associated with cervical spondylosis.
Symptom
Brachial plexus pain symptoms Common symptoms Moro response slow shoulder scapula and upper limb pain weakness scapular muscle pain shoulder movement limitation severe pain neuralgia
The pain is limited to the extent of the brachial plexus, and the stimulation or compression of the brachial plexus exacerbates the pain.
(1) Idiopathic brachial plexus or brachial plexus neuritis: refers to scapular and upper limb pain, muscle weakness and muscular atrophy syndrome (neuropathic muscle atrophy), recurrence of symptoms, autosomal dominant inheritance (No. 17 Chromosome q25 locus), more common in adults, history of infection and vaccination, acute or subacute onset, early onset with fever and systemic symptoms, usually with severe pain in the shoulder & upper extremity, upper limb muscle weakness within a few days Changes in reflexes, sensory disturbances, and C5 and C6 segments are susceptible to muscle atrophy, either unilaterally or bilaterally.
(B) secondary brachial plexus neuralgia: shoulder and upper limb pain of varying degrees, sustained or paroxysmal aggravation, night and limb activity pain, brachial plexus distribution area sensory disturbance, muscle atrophy, tendon reflex reduction, autonomic dysfunction If cervical spondylosis causes this disease, it usually starts in 40~50 years old, male is more common; slow course of disease, repeated attacks; sensory nerve roots (C5, C6 more common) pressure causes root nerve pain mostly for forearm temporal and finger Shock-like pain, accompanied by sensation; muscle pain caused by motor nerve root compression, often in the proximal limbs, shoulders, shoulder blades, persistent dull pain and deep spur-like discomfort, limited shoulder movement, long course Can cause condensed shoulders.
Examine
Brachial plexus pain check
According to its clinical manifestations, the nervous system should be examined for selective shoulder joints, cervical X-rays, cerebrospinal fluid tests, electromyography, upper limb blood flow maps, nerve conduction velocity, cervical CT or MRI.
Diagnosis
Diagnosis and differentiation of brachial plexus neuralgia
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Brachial plexus neuritis should be differentiated from shoulder arthritis, inflammation around the shoulder joint. The latter's pain is mainly located in the shoulder and upper arm. The pain is not radiated, the shoulder joint activity is obviously restricted, and the pain is intensified, while the neck activity is Does not increase the pain, shoulder muscles often have tender points, and there is no tenderness on the brachial plexus, no clinical manifestations of nerve damage, patients with periarthritis of the shoulder, when abducting their upper limbs, due to scapular movement And shrugs.
