Spinal Cord, Nerve Root, Plexopathy

The brachial plexus is the network of nerves that start in the cervical vertebrae (neck), run down both sides of the upper spinal column located in the chest ,and control the arms and hands. Injury to the brachial plexus is the most common cause of brachial plexus disorder.

In adults, injuries from sports and motorcycle accidents are leading causes. Inflammation may also affect the brachial plexus. Tumors can place stress on the brachial plexus and a rare form of infection (brachial plexitis) can cause the condition without any physical injury.

In infants, complications at birth may cause this condition. A breech presentation or prolonged labor may damage the brachial plexus, a condition known as Erb’s palsy.

To diagnose brachial plexus disorder, our team will conduct a physical exam and talk with you about your medical history and symptoms. Symptoms of brachial plexus disorder may include:

• Shoulder pain and numbness
• A burning and tingling sensation
• Weakness in the arm or hand

Your specialist may recommend additional exams or testing, such as:

• Computerized tomography myelography
• Electromyogram (EMG)
• Magnetic resonance imaging (MRI)
• Nerve conduction test

Treatment for brachial plexus disorder depends on the severity of nerve damage. Houston Methodist offers the latest treatment options, which may include:

• Avoiding activities that caused the injury
• Medication
• Physical therapy
• Rest
• Surgery
• Transcutaneous electrical nerve stimulation device (TENS)

Carpal tunnel syndrome is a condition that causes numbness, tingling and weakness in the hands and wrists. To diagnose carpal tunnel syndrome, our team uses several tests and procedures, including:

• Electromyogram (EMG)
• Family and medical history
• Nerve conduction study
• Physical exam
• X-ray

Women may be more susceptible to carpal tunnel syndrome because their carpal tunnels are smaller than those of men. Carpal tunnel syndrome is caused by compression (pinched nerve) of the median nerve in the wrist and may be due to conditions such as:

• Anatomical abnormalities
• Chronic nerve-damaging conditions such as diabetes
• Fluid retention
• Inflammatory conditions such as arthritis
• Kidney failure
• Menopause
• Obesity
• Repetitive stress movements
• Thyroid disorders

Treatment for carpal tunnel syndrome varies depending on symptoms and severity and may include:

• Cold therapy
• Corticosteroid (cortisone) injections
• NSAIDs, such as ibuprofen
• Prescription medications
• Rest
• Surgery
• Wrist splinting

Cubital tunnel syndrome is similar to carpal tunnel syndrome except the ulnar nerve is under pressure. The condition causes pain and numbness in the elbow and tingling in the ring and little fingers. Cubital tunnel syndrome is diagnosed and treated like carpal tunnel syndrome.

Radial tunnel syndrome, a similar condition, occurs when pressure is exerted on the radial nerve that passes through the elbow. The pain occurs at the top of the forearm or back of the hand, often when the wrist and fingers are straightened. Radial tunnel syndrome rarely causes numbness or tingling.

Spinal muscular atrophy, a disease that often emerges in early childhood, is a genetic disorder that affects the control of muscle movement. The condition is caused by loss of motor neurons in the spinal cord and the brainstem. This loss of neurons weakens and atrophies the muscles used for walking, crawling, sitting and controlling head movements. In severe cases, muscles used for breathing and swallowing can be affected.

To diagnose spinal muscular atrophy, our team will conduct a physical exam and discuss your symptoms and family history. We will recommend specific blood, genetic, muscle and nerve conduction tests to rule out conditions that cause similar symptoms, such as muscular dystrophy.

While there is no cure for spinal muscular atrophy, personalized treatment can help you manage symptoms and improve your quality of life.

Transverse myelitis is inflammation of the spinal cord, often targeting the myelin sheath that covers nerve cell fibers. It may cause injury across the spinal cord, affecting a person’s ability to feel sensations below the point of injury. One or both sides of the body may be affected.

To diagnose transverse myelitis, we will perform a physical exam and talk with you about your symptoms. The symptoms of transverse myelitis typically develop over a few hours and get worse over a few days and include:

• Sharp, shooting pains that start suddenly in the neck or back and radiate down the arms and legs and into the abdomen
• Sensations of numbness, tingling, coldness or burning that can cause the lightest touch to be painful
• Weakness or paralysis in the arms and legs
• Increased need — or difficulty with — urination, as well as incontinence and constipation

Your specialist may recommend tests or exams such as these to diagnose your condition:

• Blood tests
• Clinical assessment of nerve function
• Magnetic resonance imaging (MRI)
• Lumbar puncture (spinal tap)

Treatment for transverse myelitis depends on the symptoms and severity of the condition and may include:

• Antiviral drugs
• Antidepressants
• Intravenous steroids
• Occupational therapy
• Pain relievers
• Physical therapy
• Plasmapheresis (plasma exchange)