brachial plexus injury

[onpc]

i have a patient wid brachial plexus injury.reports shows degenration in c5,c6.The patinet lost all sensations and movements for his left lower limb.I tried wid galvanic stimulation for around 20 sittings and it came out witha great resposne wid hand function coming back,thn i tried faradic stimulation resulting in flexor movements genration in lower arm.currently i need suggestions for wat can be the best way to bring back mainly his biceps,triceps and deltoid back to action as stimulationa are proving out wid no results

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[marj]

The nerve will recover with time or surgery. I'm not aware of any lit that indicates electrical stim stimulates nerve regen (hastens it) but if others are then please post. The patient should continue to maintain mobility while awaiting nerve regen (assuming it is an incomplete lesion of the trunk). Marj

[alanes1]

You need a definitive diagnosis as to where the lesion is. Obviously if it is a root avulsion it will need a surgical repair but the outcome is often poor. All roots must have been affected initially with the residual Erb's palsy left. This is the more common lesion of the brachial injuries.
As the previous writer said you or the surgeon have two options. Wait and see commonly 6 months or investigative surgery now. If it is an axontemeses it will come back in 6 to 12 months depending on the rate of growth of the axon. If it is a neurotemesis it is unlikely to return and will need surgical intervention. An MRI should tell you this.
Personnally I would like to know exactly what I am dealing with.
Alan Esnouf

[neving]

my guess is that there was some swelling in the area, which has now subsided, and so you have some functional recovery in areas supplied by nerves from lower levels of the C/S.
neving

[sarah b]

I have found hydrotherapy a very useful tool to facilitate mustle activation through range.

[onpc]

well thanks for all ur suggestions. lastest picture is (N.C.V) is showing normal conduction from left erbs to deltoid,supra spinatus biceps and triceps.No neurotomesis . pt. has gained wrist movements and mainly flexor comapartment forearm is doing well.I will definetly give a try wid hydrotherapy ,currentlt i m using galvanic stimulations.Plz guide me up further

[prem]

hi
i'm new to physio forum. i need some info about erb's palsy management. i've read about the improvement of the same condition in ur mail.pls guide me about electrical stim usage to improve shoulder abduction and extension. a patient (11 yrs) at present can abduct to 90 degrees actively and to 110 when assisted.now pt is given an exercise regime to strengthen her shoulder abductors and extensors. is electrical stim helpful in this condition? if yes, pls let me know the mode of current to be used. no sensory loss and all other UL movements are normal.

bye.
Prem.