Prognostic value of needle electromyography in traumatic brachial plexus injury

David M. Impastato*, Katherine A. Impastato, Parinaz Dabestani, Jason Hyunsuk Ko, Aaron E. Bunnell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Introduction: In this study we aimed to determine whether needle electromyographic assessment of voluntary motor unit recruitment in traumatic brachial plexus injuries could predict spontaneous motor recovery. Methods: A retrospective study was performed on patients with brachial plexus injury affecting deltoid, supraspinatus/infraspinatus, and biceps brachii. The outcome measure was strength on manual muscle testing at least 1 year after injury. Good outcome was considered strength >3/5 on the Medical Research Council (MRC) scale. Results: No muscles with no recruitment (n = 27) at 1-9 months improved to MRC 4/5 strength at a mean of 2.0 years postinjury. Twenty-five percent of muscles with discrete or severely reduced recruitment (n = 8) regained strength to >3/5 at a mean of 1.4 years postinjury (P =.047). Discussion: Absent voluntary motor unit potential recruitment at 1-9 months predicted poor prognosis for spontaneous recovery. A high percentage of patients with discrete recruitment did not improve to >3/5 strength. These patients should be considered for early nerve transfer surgery.

Original languageEnglish (US)
Pages (from-to)595-597
Number of pages3
JournalMuscle and Nerve
Issue number5
StatePublished - Nov 1 2019


  • brachial plexus injury
  • motor unit potential recruitment
  • nerve reconstruction
  • nerve transfer
  • upper trunk

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)
  • Cellular and Molecular Neuroscience
  • Physiology


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