분만 상완신경총 손상에서 Breathing Arm과 Breathing Hand의 운동 신경 재생 -증례 보고-
Motor Nerve Regeneration in Obstetric Brachial Plexopathy Associated with Co-Existence of Breathing Arm and Hand
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It has been reported that “breathing arm” or “breathing hand” phenomenon is related to the motor nerve regeneration not only between injured brachial plexus and C3-C5 but also between injured brachial plexus and upper thoracic nerve roots in obstetric brachial plexus injury (OBPI). To the best of our knowledge, the co-existence of “brea thing arm” and “breathing hand” is very rare in OBPI. We present one OBPI case with respiratory synkinesis on the arm and hand, identified through electromyographic investigations. Although the cervical magnetic resonance image, the electrophysiologic studies and functional evaluations demonstrated severe OBPI from C5 to T1 level around nerve roots, transcranial magnetic stimulation study showed electrical potentials evoked in proximal arm and distal hand. These suggest the reorganization of cervical, thoracic nerve roots and injured brachial plexus. Therefore, the concurrent existence of “breathing arm” and “breathing hand” would be a sign of neuronal plasticity rather than functional improvement in OBPI.
Abstract
It has been reported that “breathing arm” or “breathing hand” phenomenon is related to the motor nerve regeneration not only between injured brachial plexus and C3-C5 but also between injured brachial plexus and upper thoracic nerve roots in obstetric brachial plexus injury (OBPI). To the best of our knowledge, the co-existence of “brea thing arm” and “breathing hand” is very rare in OBPI. We present one OBPI case with respiratory synkinesis on the arm and hand, identified through electromyographic investigations. Although the cervical magnetic resonance image, the electrophysiologic studies and functional evaluations demonstrated severe OBPI from C5 to T1 level around nerve roots, transcranial magnetic stimulation study showed electrical potentials evoked in proximal arm and distal hand. These suggest the reorganization of cervical, thoracic nerve roots and injured brachial plexus. Therefore, the concurrent existence of “breathing arm” and “breathing hand” would be a sign of neuronal plasticity rather than functional improvement in OBPI.
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