Transient brachial plexopathy in adults and children: a literature review

Abstract

BACKGROUND: Transient brachial plexopathy such as burner or stinger syndrome is a mild injury of the brachial plexus caused by forced movements of the arm or cervical spine, less often by direct impact of a traumatic factor in the supraclavicular region. It occurs mainly in athletes involved in contact sports. Clinically, transient brachial plexopathy is characterized by a sudden, sharp, stabbing pain that spreads from the neck to the fingertips and usually lasts from a few seconds to several minutes. Considering the lack of Russian literature on this disease, this article will be useful for trauma orthopedists, neurologists, sports doctors, trainers and rehabilitation specialists.

AIM: The aim of this paper was to review current data on the pathogenesis, diagnosis, and treatment of transient brachial plexopathy and ways to maintain the ability of patients to participate in sports.

MATERIALS AND METHODS: Publications were searched in PubMed (MEDLINE) databases and Google from 1965 to 2024 using combinations of OR, AND operators and keywords such as “transient brachial plexopathy,” “stinger syndrome”, “burner syndrome”, “sports medicine”, “children.” A total of 49 papers were selected, 13 of which were published in the last 10 years.

RESULTS: The disease is diagnosed in 18.8%–65.0% of American football and rugby players. Stinger syndrome is reported in children when they fall from a chair and hit their shoulder on a table, when they hit a wall while running, accompanied by a sharp tilt of the head to the opposite side of the shoulder lesion. It is also reported in patients with shoulder hypermobility. Transient brachial plexopathy is caused by damage to the C₅–C₆ roots of the spinal cord or upper trunk of the brachial plexus. The pain syndrome usually lasts from a few seconds to a few minutes. It may be accompanied by paresthesia, numbness, and weakness of the upper extremity. Most symptoms of stinger syndrome (55.5%) develop during competition and resolve less than 24 hours after the game (63.8%). If the stinger syndrome resolves quickly, the patient does not require further evaluation or treatment. Indications for imaging include attacks lasting more than one hour with associated neck pain, symptoms topically associated with local nerve root damage, and recurrent attacks.

CONCLUSIONS: Early diagnosis and competent management of athletes with transient brachial plexopathy, as well as improved playing technique, may prevent or reduce recurrent attacks. It is important to remember that this disease can occur in both adults and children, even in everyday life.

Keywords

transient brachial plexopathy / stinger syndrome / burner syndrome / sports medicine / children

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