Journals / Turkish Journal of Pediatrics / 2021 / Cilt: 63 - Sayı: 1

Brachial plexopathy as a consequence of nerve root swelling after shoulder trauma in a patient following an acute seizure

Pages
161–166
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The early detection of swelling compression, accompanied with appropriate therapy may prevent the progression of axonal damage and preserve the functional status of the affected limb.

📌 3 Key Takeaways

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Objective & Hypothesis:Epileptic seizures might be associated with an increased risk of fractures, either as a result of trauma after a fall or as a result of excessive muscle contraction.
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Key Findings & Data:In the pediatric population, excessive muscle contraction is a more significant risk factor for fractures, due to the lack of maturity in the musculoskeletal system, while antiepileptic therapy itself can lead to a reduction of bone density.
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Conclusion & Impact:The early detection of swelling compression, accompanied with appropriate therapy may prevent the progression of axonal damage and preserve the functional status of the affected limb.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background. Epileptic seizures might be associated with an increased risk of fractures, either as a result of trauma after a fall or as a result of excessive muscle contraction. In the pediatric population, excessive muscle contraction is a more significant risk factor for fractures, due to the lack of maturity in the musculoskeletal system, while antiepileptic therapy itself can lead to a reduction of bone density. Proximal humeral fractures in the pediatric population are not frequent but both proximal humeral fractures and shoulder dislocation increase the chance of brachial plexus injuries and peripheral nerve lesions. Case. In this case report, we present a patient who suffered both avulsive greater tuberosity humeral fracture and anterior shoulder dislocation, initially diagnosed by radiography, with consequent brachial plexus injury of the left arm after an epileptic seizure followed by excessive muscle contraction. Electromyoneurography initially showed amplitudes’ reduction in tested nerves along with signs of muscle denervation as well as clinical examination signs of the left arm muscular hypotrophy and hypoesthesia, especially in the left humero-scapular region. Electrotherapy and kinesitherapy as well as intramuscular dexamethasone injections administered three weeks after the injury finally improved the clinical examination findings in the patient. Conclusion. The early detection of swelling compression, accompanied with appropriate therapy may prevent the progression of axonal damage and preserve the functional status of the affected limb.

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Cite This Article

MİLANOVİĆ, F., ABRAMOVIC, D., DUCIC, S., BUKVA, B., DASIC, I., RADOVIC, T., MISKULIN, A. C. P., NIKOLIC, D. (2021). Brachial plexopathy as a consequence of nerve root swelling after shoulder trauma in a patient following an acute seizure. Turkish Journal of Pediatrics, Cilt: 63 - Sayı: 1, 161–166. https://ajindex.com/articles/411807

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References (15)

  1. Ach K, Slim I, Ajmi ST, Chaieb MC, Beizig AM, Chaieb L. Non-traumatic fractures following seizures: two case reports. Cases J 2010; 3: 30
  2. Bühler M, Gerber C. Shoulder instability related to epileptic seizures. J Shoulder Elbow Surg 2002; 11: 339-344
  3. Thangarajah T, Lambert SM. Management of recurrent shoulder instability in patients with epilepsy. J Shoulder Elbow Surg 2016; 25: 1376-1384
  4. Thangarajah T, Falworth M, Lambert SM. Anatomical shoulder arthroplasty in epileptic patients with instability arthropathy and persistent seizures. J Orthop Surg (Hong Kong) 2017; 25: 2309499017717198
  5. Goudie EB, Murray IR, Robinson CM. Instability of the shoulder following seizures. J Bone Joint Surg Br 2012; 94: 721-728
  6. Suryavanshi A, Mittal A, Dongre S, Kashyap N. Bilateral anterior shoulder dislocation with symmetrical greater tuberosity fracture following seizure. J Orthop Case Rep 2012; 2: 28-31
  7. Ahmad K, Ayaz SB, Khalil HB, Matee S. Bilateral spontaneous anterior shoulder dislocation: a missed orthopedic injury mistaken as proximal neuropathy. Chin J Traumatol 2017; 20: 370-372
  8. Camfield C, Camfield P. Injuries from seizures are a serious, persistent problem in childhood onset epilepsy: a population-based study. Seizure 2015; 27: 80-83
  9. Wirrell EC. Epilepsy-related injuries. Epilepsia 2006; 47 (Suppl 1): 79-86
  10. Fernández-Torre JL, Vázquez JL, Leno C. Brachial plexopathy following a generalized tonic-clonic seizure. Eur J Neurol 2007; 14: e14
  11. Singer AD, Meals C, Kesner V, et al. The multidisciplinary approach to the diagnosis and management of nonobstetric traumatic brachial plexus injuries. AJR Am J Roentgenol 2018; 211: 1319-1331
  12. Jovanovich EN, Howard JF Jr. Brachial plexus injury in a 6-year-old boy with 100% displaced proximal humeral metaphyseal fracture: a case presentation. PM R 2017; 9: 1294-1298
  13. Dorsi MJ, Hsu W, Belzberg AJ. Epidemiology of brachial plexus injury in the pediatric multitrauma population in the United States. J Neurosurg Pediatr 2010; 5: 573-577
  14. Hems TE, Mahmood F. Injuries of the terminal branches of the infraclavicular brachial plexus: patterns of injury, management and outcome. J Bone Joint Surg Br 2012; 94: 799-804
  15. Gagliardo A, Toia F, Maggi F, Mariolo AV, Cillino M, Moschella F. Clinical neurophysiology and imaging of nerve injuries: preoperative diagnostic work-up and postoperative monitoring. Plast Aesthet Res 2015; 2: 149-155.