Electrodiagnosis of Plexopathy

Abstract

Electrodiagnostic evaluation of the brachial and lumbosacral plexus can be challenging even to an experienced practitioner. Detailed attention to anatomy and correlation with the history and physical examination results are needed to have a comprehensive differential diagnosis and to develop reliable conclusions. Electrophysiologic techniques, when applied appropriately, provide invaluable functional information after a plexus injury. Electrodiagnostic evaluation of a plexus injury should be systematic and comprehensive to provide the maximum precision for localization, extent of involvement, and severity of injury.

Innervation of the Long Head of the Triceps Brachii in Humans—A Fresh Look

“…Another limitation in many studies, including ours, is the number of cadaveric specimens. Additionally, EMG studies would also be helpful to analyze the innervation of the LHT in vivo (Strakowski, ).…”

“…All triceps heads are radial nerve innervated Almost all textbooks (Thomson et al, 1882;Lockhart et al, 1959;Zuckerman, 1963;Romanes, 1964;Mathers, 1985;Standring, 2008;Moore et al, 2013), with one exception (see below: Diogo et al, 2016) The long head is also axillary nerve innervated and without citing de Sèze et al (2004) without own investigations Diogo et al (2016) wrote a very good modern text book as guide for medical anatomical education, on page 147 they state, that the triceps is mainly innervated by radial nerve, "but also axillary n. for long head". The long head is axillary nerve innervated and citing de Sèze et al (2004) without own investigations Example for variable innervation of triceps (Miguel-P erez et al, 2010;Howard, 2017); mentioned in discussion (Tashjian et al, 2008;Kim et al, 2012;Yılmaz et al, 2015;Stastny et al, 2017); mentioned as part of review of neuropathies (Popinchalk and Schaffer, 2012;Strakowski, 2013); mentioned in introduction (Sawant, 2013;Wang and Weiss, 2013); "This explains why the triceps long head motor branch may be affected in patients with axillary nerve injury [16 5 de Sèze et al (2004)]. " (Bertelli and Ghizoni, 2014); LHT is mostly axillary innervated (Lindsey and Voloshin, 2015); Axillary nerve divides into an anterior and posterior branch and "occasionally has a collateral branch to the long head of the triceps.63 5 de Sèze et al (2004) Motor branch of LHT should be considered as axon recipients from platysma motor branch (Socolovsky et al, 2008); "In the arm, the radial nerve can be frequently injured .…”

Lumbosacral Plexopathies: Causing by Femoral Head Fracture

“…The hallmarks of electrodiagnostic study for lumbosacral plexopathies are spontaneous activity in peroneal, tibial, sciatic, superior gluteal and inferior gluteal innervated muscles. The motor and sensory nerve conduction studies of an affected lower limb reveal diminished or no electrical response [8]. This report showed lumbosacral plexopathies from uncommon cause: femoral fracture.…”

Musculoskeletal ultrasound for traumatic and torsional alterations

“…79,80 Localizing multiple lesions in the brachial plexus can be challenging. 81,82 Tracing the innervation of affected muscles through the brachial plexus back to their root origins helps identify multiple lesions. 83,84 In the lower limb, bullets tend to cause injury to upper quadrants of the lumbosacral plexus with relative sparing of the lower portion due to shielding by the pelvic ring.…”

“…By contrast, a bullet can lead to multiple disconnected lesions 79,80 . Localizing multiple lesions in the brachial plexus can be challenging 81,82 . Tracing the innervation of affected muscles through the brachial plexus back to their root origins helps identify multiple lesions 83,84 .…”