Rucksack paralysis: Difference between revisions

(Created page with "==Background== * Brachial plexus injury as a consequence of carrying a heavy backpack frequently described in military population <ref>McCulloch, R., Sheena, Y., Simpson, C.,...")
 
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==Background==
==Background==
* Brachial plexus injury as a consequence of carrying a heavy backpack frequently described in military population <ref>McCulloch, R., Sheena, Y., Simpson, C., et al. Brachial plexus palsy following a training run with a heavy backpack. ''J R Army Med Corps'' October 14, 2013 doi: 10.1136/jramc-2013-000139.</ref>
* Brachial plexus injury as a consequence of carrying a heavy backpack frequently described in military population <ref>McCulloch, R., Sheena, Y., Simpson, C., et al. Brachial plexus palsy following a training run with a heavy backpack. ''J R Army Med Corps'' October 14, 2013 doi: 10.1136/jramc-2013-000139.</ref>
* Seen also in boy scouts, hikers, mountaineering <ref> Nylund T, Mattila VM, Salmi T, et al. Recovery of brachial plexus lesions resulting from heavy backpack use: a follow-up case series. ''BMC Musculoskelet Disord'' 2011;12:62. </ref>, <ref>White HH. . Pack palsy: a neurological complication of scouting. ''Pediatrics'' 1968; 41:1001–3.</ref>
* Seen also in boy scouts, hikers, mountaineering <ref> Nylund T, Mattila VM, Salmi T, et al. Recovery of brachial plexus lesions resulting from heavy backpack use: a follow-up case series. ''BMC Musculoskelet Disord'' 2011;12:62. </ref><ref>White HH. . Pack palsy: a neurological complication of scouting. ''Pediatrics'' 1968; 41:1001–3.</ref>
* Also described secondary to wearing body armor <ref>Bhatt BM. ‘Top Cover Neuropathy’—Transient brachial plexopathy due to body armour. ''JRAMC'' 1990;136:53–4.</ref>
* Also described secondary to wearing body armor <ref>Bhatt BM. ‘Top Cover Neuropathy’—Transient brachial plexopathy due to body armour. ''JRAMC'' 1990;136:53–4.</ref>
* Known by a variety of names over the years from pack palsy <ref>Bom F. . A case of pack-palsy from the Korean War . ''Acta Psychiatr Neurol Scand'' 1953; 28:1–4.</ref> , backpack palsy, rucksack paralysis <ref>Daube JR. . Rucksack paralysis. ''JAMA'' 1969; 208:2447–52.</ref>, trekker's palsy, Pallbearer's palsy <ref> Loni NK. . Pall-bearer's palsy . ''BMJ'' 1966; 2:808–9.</ref>
* Known by a variety of names over the years from pack palsy <ref>Bom F. . A case of pack-palsy from the Korean War . ''Acta Psychiatr Neurol Scand'' 1953; 28:1–4.</ref> , backpack palsy, rucksack paralysis <ref>Daube JR. . Rucksack paralysis. ''JAMA'' 1969; 208:2447–52.</ref>, trekker's palsy, Pallbearer's palsy <ref> Loni NK. . Pall-bearer's palsy . ''BMJ'' 1966; 2:808–9.</ref>

Revision as of 09:12, 27 February 2018

Background

  • Brachial plexus injury as a consequence of carrying a heavy backpack frequently described in military population [1]
  • Seen also in boy scouts, hikers, mountaineering [2][3]
  • Also described secondary to wearing body armor [4]
  • Known by a variety of names over the years from pack palsy [5] , backpack palsy, rucksack paralysis [6], trekker's palsy, Pallbearer's palsy [7]
  • Decreased because of more ergonomically designed packs [8]

Clinical Features

  • Signs and symptoms vary depending on severity and location of injury
  • Most often present unilateral
  • Onset may be acute or subacute
  • Minor - electric shock, burning sensation shooting down the arm, numbness/weakness in arm
  • Severe - weakness, inability to use certain muscles of hand/arm/shoulder, complete lack of movement or feeling in arm, severe pain

Differential Diagnosis

Parsonage-Turner syndrome
Toxic neuropathy
Progressive neuropathy secondary to exposure (lead, mercury, heavy metals, chemical solvents)

Evaluation

  • History and clinical examination
  • Electrodiagnostic studies EMG, NCV
  • Imaging studies CT, MRI

Management

  • Refrain from back use short term when patient resumes use a back with a frame and hip belt as this will reduce incidence of backpack palsy [9]
  • Surgical consultation
  • Physical therapy / occupational therapy

Disposition

  • Patients usually make full recovery
  • Outpatient treatment and follow-up with orthopedics if minor

See Also

Brachial plexus injury

External Links

References

  1. ↑ McCulloch, R., Sheena, Y., Simpson, C., et al. Brachial plexus palsy following a training run with a heavy backpack. J R Army Med Corps October 14, 2013 doi: 10.1136/jramc-2013-000139.
  2. ↑ Nylund T, Mattila VM, Salmi T, et al. Recovery of brachial plexus lesions resulting from heavy backpack use: a follow-up case series. BMC Musculoskelet Disord 2011;12:62.
  3. ↑ White HH. . Pack palsy: a neurological complication of scouting. Pediatrics 1968; 41:1001–3.
  4. ↑ Bhatt BM. ‘Top Cover Neuropathy’—Transient brachial plexopathy due to body armour. JRAMC 1990;136:53–4.
  5. ↑ Bom F. . A case of pack-palsy from the Korean War . Acta Psychiatr Neurol Scand 1953; 28:1–4.
  6. ↑ Daube JR. . Rucksack paralysis. JAMA 1969; 208:2447–52.
  7. ↑ Loni NK. . Pall-bearer's palsy . BMJ 1966; 2:808–9.
  8. ↑ De Luigi AJ, Pasquina P, Dahl E. Rucksack induced plexopathy mimicking a lateral antebrachial cutaneous neuropathy. Am J Phys Med Rehabil 2008;87:773–5.
  9. ↑ Knapik JJ, Reynolds KL, Harman E. Soldier load carriage: historical, physiological, biomechanical and medical aspects. Mil Med 2004; 169: 45-56.
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