Axillary nerve involvement in hemiplegia

ABSTRACT Objective: Brachial plexus and peripheric nerves of the upper extremities can be damaged in hemiplegic shoulder subluxation. This study aimed to determine the relationship between shoulder subluxation and axillary nerve injury. Methods: Sixty patients with stroke were included in the study. The Brunnstrom Scale  and the Ashworth Scale were used to evaluate the  motor and muscle tone, respectively. Functional evaluation was performed with the Fugl–Meyer Scale and the Stroke Impairment Assessment Set . The Van Langenberghe method was used to grade shoulder subluxation on anterior-posterior shoulder X-ray. Latencies and amplitudes of the axillary nerves of the normal and hemiplegic sides were compared using electromyographs. Results: The latency of the axillary nerves of the hemiplegic sides (4.,2±0.,75  msn) was prolonged when compared to that of the normal sides (3.,7±0.,7 msn), and this difference was statistically significant (P<0.,001). The amplitudes of the compound muscle action potential of the hemiplegic sides (4.,1±4.,22 mv)  lower than that of the normal sides (6.,1±6.,57 mv) (P<0.,001). Conclusions: Shoulder subluxation may cause injury not only to the  axillary nerve but also to other peripheric nerves and the brachial plexus.  Detecting shoulder subluxation and additional axillary nerve injury could in help planning an appropriate rehabilitation program and contribute to functional recovery by preventing complications.