View source for BRACHIAL PLEXUS INJURY-INVESTIGATIONS

===== [[Summary Article|'''SUMMARY''']] =====
1. MRI cervical spine and brachial plexus: useful to detect post-ganglionic injuries and avulsion, disc prolapse or fibrous band causing outlet syndrome.
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<br/>2. Myelogram: useful to detect pre-ganglionic lesions and avulsion, disc prolapse.
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<br/>3. NCS/EMG: SNAP to detect lesion distal to the DRG, CNAP to detect lesions proximal to the DRG.
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<br/>4. X-ray/CT: to detect clavicle, rib, cervical fractures and shoulder dislocations and fractures or cervical rib.
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<br/><i>PROGNOSTICATION</i>
<br/>5. Prognosticating injury and predicting the occurrence of CRPS with NCS &amp; EMG: particularly noting compound nerve action potential (CNAP) for prognosis &amp; EMG as predictor for complex regional pain syndrome (CRPS). 
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<br/>6. SNAP &amp; CNAP can be used to determine if the injury is distal or proximal to the DRG (poorer prognosis in preganglionic lesions).
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<br/>7. The amplitude of the distal CMAP starts to drop by day 3 following the injury, and it reaches its lowest valve by day 7 [1]. Hence, the severity of the lesion can be judged after 7 days of the injury.


==Reference(s)==
1. Wilbourn AJ. Assessment of the Brachial Plexus and the Phrenic nerve. In: Pease WS, Johnson EW, editors. Practical Electromyography. 3rd ed. Baltimore: Williams and Wilkins; 1997. pp. 273–310.</div>
<br/>Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. [https://amzn.to/3SaP42r Get it on Amazon.]
<br/>Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. [https://amzn.to/417imTk Get it on Amazon.]
<br/>O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. [https://amzn.to/3Kc2MA2 Get it on Amazon.]

[[Category:Brachial Plexus Injury]]
[[Category:Rehabilitation]]