Brain, Nervous System and Mental Conditions

Brachial Plexus Palsy Symptoms and Diagnosis

Symptoms of Brachial Plexus Palsy

Babies and children with brachial plexus palsy may have these symptoms:

  • Weak or limp arm and sometimes wrist and hand
  • Arm, wrist or hand position that is not normal, like the arm turning inward or the wrist and hand curling down
  • Bent elbow because the joint is very tight
  • Trouble moving their arm, wrist or hand, or trouble controlling the movement
  • Pain in their arm or hand
  • Numbness or trouble feeling their arm or hand
  • Problems with the position or formation of the shoulder because of muscle weakness or an imbalance

Symptoms may range from mild to serious. This depends on how badly the nerves are damaged. For some children, the nerves only get stretched. For others, the nerves are torn or disconnected.

  • If your child's nerves are stretched, the brachial plexus palsy tends to be only short-term. It usually gets better quickly on its own.
  • If your child's nerves are torn, the brachial plexus injury is more serious. If the nerves are only partly torn, they may be able to grow back. But if the injury is too serious, or if it causes a lot of scarring, the nerve fibers may not regrow to reach the muscle. Without treatment, your child may not have enough strength to use their arm muscles in the future.
  • If your child's nerves are completely torn, or if nerves are torn away from the spinal cord, your child will not recover the use of their arm muscles without treatment.

Brachial Plexus Palsy Diagnosis

Your child's doctor will check your child to learn about their injury and how it affects their arm and hand. An exam can help the doctor assess the strength in your child's muscles and how well your child can move their joints.

Your doctor may do imaging studies to decide the right treatment at the right time. Ultrasound shows us how your child’s shoulder is developing. We use ultrasound at regular intervals, starting when babies are as young as 3 months. If we see problems with the shoulder joint, we can start splinting early to help hold the joint in the right position.

In some cases, your doctor may order MRI (magnetic resonance imaging). This can show if a nerve is detached near the spine.

Sometimes, the doctor may also order nerve tests that can help to assess your child's nerves.

There is no single test that can tell us how serious your child's injury is. Over time, the brachial plexus team will repeat tests and examine your child again. This can help them know more about where the injury is and how serious it is.

Repeated tests and exams can also help the team tell how quickly your child is getting better. If your child gets better quickly, the injury is probably less serious. If your child does not get better quickly, the injury may be more serious.