Sensory Nerve Conduction in Brachial Plexopathy: Contribution in Lesion Localization

A BSTRACT Aim: This study aims to investigate the contribution of bilateral comparative sensory nerve conduction studies (sNCS) in localizing brachial plexopathy (BP) at the trunk level. Subjects and Methods: In this retrospective study, we evaluated 79 adult patients with BP, 40 adult controls, and 36 pediatric patients with BP. Bilateral antidromic sNCS of the median (M1, M2), ulnar (U5), radial superficial (RS), medial antebrachial cutaneous (MABC), and lateral antebrachial cutaneous (LABC) nerves were conducted. Abnormalities were identified by decreased or absent sensory nerve action potentials or significant bilateral amplitude differences (>50%). Results: In adult patients with BP, bilateral comparative studies significantly enhanced the detection of abnormalities in M1 (46.7% vs. 100%, P < 0.001), M2 (42.7% vs. 86.7%, P < 0.001), RS (44.9% vs. 77.6%, P < 0.001), and U5 (59% vs. 87.2%, P = 0.001). In upper + middle trunk involvement, M1, M2, and LABC showed the highest abnormality rates, and U5 and MABC were predominant in lower trunk involvement. The findings of pediatric patients with BP mirrored those of adults, with M1 showing the highest abnormality rate (97.2%) in upper + middle trunk involvement, and bilateral studies significantly increased abnormality detection in M2 (33.3% vs. 88.9%, P < 0.001). Conclusions: Bilateral comparative sNCS significantly improved the detection of nerve abnormalities in BP, particularly in the M1, M2, U5, and RS nerves. The results confirm the utility of sensory conduction studies in localizing BP lesions at the trunk level in both adult and pediatric patients. These findings emphasize the importance of bilateral comparative sNCS in accurately diagnosing BP.