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Journal of the Korean Academy of Rehabilitation Medicine 1997;21(6):1236-1243.
Brachial Plexopathy Associated with Thoracoscopic Sympathectomy for Treatment of Primary Hyperhidrosis: A Case Report.
Moon, Jeong Lim , Kang, Sae Yoon , Yang, Seung Han , Shin, Ji Nam
Department of Rehabilitation Medicine, The Catholic University of Korea, School of Medicine, Korea.
흉강경을 통한 교감신경절제술후 발생한 상완신경총손상
문정림, 강세윤, 양승한, 신지남
가톨릭대학교 의과대학 재활의학교실
Brachial plexus is vulnerable to injury because it is close to shoulder joint of which the range of motion is very large and it is surrounded by many complex structures. Iatrogenic injuries are commonly associated with surgeries such as procedures in the posterior neck or in the shoulder and open thoracotomy, during regional anesthetic blocks, and during other procedures that use needles and cannulas. Radiation therapy can cause brachial plexus injury. A case of brachial plexus injury after thoracoscopic sympathectomy for treatment of primary hyperhidrosis is discussed in this report. Twenty eight years old male patient developed motor and sensory paralysis of Rt. upper extremity shortly after thoracoscopic sympathectomy performed with hyperabduction position of Rt. upper extremity for 2 hours and 30 minutes. Electrodiagno stic study was performed on the 11th day after paralysis. Electrodiagnostic findings from the which was compatible with showed abnormal spontaneous activities at rest and decreased numbers of MUAPs on volition sampled muscles innervated by brachial plexus. The motor power of these muscles was trace or fair grade. On the 14th day after paralysis the patient recoverd the motor power to near nomal on muscle testing. The reason of this complication is not clear, but it might have occurred most likely in association with tension and traction forces applied to patient's brachial plexus while hyperabducting the arm for a long period of time during surgery. In this study we have reviewed perioperative brachial plexus injuries and their possible mechanisms, of injury hoping to decrease the occurrence of perioperative brachial plexus injuries.
Key Words: Thoracoscopy, Brachial plexus injury, Position, Thoracoscopy, Sympathectomy, Hyperhidrosis


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