Patients with hand and arm paralysis may have a greater chance of restoring function thanks to a specialized nerve reconstruction procedure now offered at Valley Regional Medical Center.
James Berry, DO, a board-certified neurosurgeon, performs the procedure at Valley Regional Medical Center (VRMC) for patients with brachial plexus injuries and other complex peripheral nerve conditions. By offering this rare specialty locally, VRMC is helping expand access to advanced nerve care that often requires patients to travel outside the region.
Brachial plexus injuries affect the complex network of nerves in the neck and shoulder that controls movement and sensation in the arm and hand. These injuries are rare, but when they occur, they can cause sudden weakness, numbness, loss of sensation or even complete loss of arm function.
"Brachial plexus and peripheral nerve injuries can be life-changing," Dr. Berry said. "But with timely evaluation and the right treatment plan, some patients may be able to regain meaningful function."
Because brachial plexus and peripheral nerve reconstruction require advanced expertise, patients often have to seek care out of market. By offering this rare specialty locally, Dr. Berry is helping increase access to complex nerve repair for patients who might otherwise need to travel for evaluation, surgery, follow-up and therapy.
"The brachial plexus is one of the most complex regions in the human body," Dr. Berry said. "What makes this field so rewarding is that even when someone has a devastating nerve injury, there may still be an opportunity to restore meaningful function."
Brachial plexus injuries can result from motorcycle crashes, falls, penetrating wounds, gunshots or trauma that stretches or tears the nerves. In newborns, these injuries can occur during difficult deliveries when the baby's neck or arm is stretched. Tumors can also affect the brachial plexus, including nerve sheath tumors such as schwannomas, neurofibromas, plexiform neurofibromas and, in rare cases, malignant tumors involving the nerve.
For patients with tumors, symptoms may develop gradually rather than suddenly. A tumor growing in or near the nerve can cause progressive pain, numbness, tingling, weakness or loss of function. Depending on the tumor type and location, surgery may involve removing the tumor while preserving as much nerve function as possible. In some cases, the damaged nerve may also need to be reconstructed or repaired.
Early evaluation is critical. Some stretch injuries may improve on their own, but others require surgical repair. If a patient does not regain significant function within several months, surgery may be recommended. After about a year, repair options can become much more limited because the connection between the nerve and muscle may no longer respond well.
Treatment may include nerve repair, nerve transfers or nerve grafting. In some cases, surgeons can use donated human nerve tissue to bridge gaps where nerves have been damaged, allowing nerve fibers to grow through the graft over time.
Recovery is gradual. Patients usually do not see immediate improvement after surgery, and progress may take months. Early recovery can be slow, with noticeable changes often beginning several months after repair and continued improvement over the course of a year or longer.
Therapy also plays an important role. Depending on the injury and procedure, patients may work with occupational or physical therapists to rebuild strength, coordination and use of the affected arm or hand.
For patients who have lost arm or hand function, even partial recovery can be life-changing. Restoring the ability to pick up a cup, eat a meal, hold a toothbrush or perform other daily tasks can significantly improve independence and quality of life.
"One of the biggest misconceptions is that these injuries are always permanent," Dr. Berry said. "With timely evaluation and the right treatment plan, some patients can regain meaningful use of the arm or hand."
For patients and families facing a sudden or progressive loss of arm function, access to this specialized care at Valley Regional Medical Center offers the chance to seek expert evaluation without having to travel far from home.