Post-ICU brachial plexus and peripheral nerve injury

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Camden
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Complications in the post-ICU Covid-19 population include brachial plexopathy and common peroneal nerve injury, and may require immediate referral to the RNOH PNI unit +/- phone or email discussion. Please also be aware that early referral is recommended rather than waiting for neurophysiology tests.

Those requiring immediate referral include acute presentations after a precipitating incident, ie. proning in ICU (or other specific incident) with either:

  • neuropathic type pain, and/or total loss of function of one branch (no sympathetics, sensation or motor) regardless of duration

OR

  • painless neuropraxia (conduction block) – patchy distribution with intact sensation and sympathetics and incomplete motor involvement – which has not improved or resolved three weeks post-onset.

​For any patient presenting with neuropathic pain +/- conduction block without a precipitating incident/ICU admission, please assess and manage as usual, referring to Camden MSK for suspected MSK presentations. Camden MSK can assess both remotely and face-to-face if appropriate, and refer on appropriately including to the RNOH PNI unit where required.


Eligibility criteria

Inclusions

  • patient presenting with neuropathic pain after ICU admission for Covid-19
  • patient presenting with total loss of function in single branch (+/- pain) after ICU admission for Covid-19
  • patient presenting with conduction loss unresolved three weeks post onset, after ICU admission for Covid-19

How to refer

The following clinicians can refer to this service: