Over the past 2 decades, the surgical treatment of brachial plexus and peripheral nerve injuries has advanced considerably. Nerve transfers have become an important surgical tool in addition to nerve repair and grafting. Electrodiagnosis has traditionally played a role in the diagnosis and localization of peripheral nervous system injuries, but a different approach is needed for surgical decision-making and monitoring recovery. When patients have complete or severe injuries they should be referred to surgical colleagues early after injury, as outcomes are best when nerve transfers are performed within the first 3 to 6 mo after onset. Patients with minimal recovery of voluntary activity are particularly challenging, and the presence of a few motor unit action potentials in these individuals should be interpreted on the basis of timing and evidence of ongoing reinnervation. Evaluation of potential recipient and donor muscles, as well as redundant muscles, for nerve transfers requires an individualized approach to optimize the chances of a successful surgical intervention. Anomalous innervation takes on new importance in these patients. Communication between surgeons and electrodiagnostic medicine specialists (EMSs) is best facilitated by a joint collaborative clinic. Ongoing monitoring of recovery post-operatively is critical to allow for decision making for continued surgical and rehabilitation treatments. Different electrodiagnostic findings are expected with resolution of neurapraxia, distal axon sprouting, and axonal regrowth. As new surgical techniques become available, EMSs will play an important role in the assessment and treatment of these patients with severe nerve injuries.

中文翻译：

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电诊断在局灶性神经病和臂丛神经病的神经转移中的作用

在过去的 20 年里，臂丛神经和周围神经损伤的外科治疗取得了长足的进步。神经移植已成为除神经修复和移植外的重要手术工具。电诊断传统上在周围神经系统损伤的诊断和定位中发挥作用，但手术决策和监测恢复需要不同的方法。当患者有完全或严重的损伤时，他们应该在受伤后及早转诊给外科同事，因为在发病后的前 3 到 6 个月内进行神经转移时效果最好。自愿活动恢复最少的患者尤其具有挑战性，并且这些个体中存在一些运动单位动作电位应根据持续神经支配的时间和证据进行解释。评估潜在的受体和供体肌肉以及多余的肌肉以进行神经转移需要采用个性化的方法来优化成功手术干预的机会。异常神经支配在这些患者中具有新的重要性。联合协作诊所最好地促进外科医生和电诊断医学专家 (EMS) 之间的沟通。对术后恢复的持续监测对于做出继续手术和康复治疗的决策至关重要。随着神经失用、远端轴突发芽和轴突再生的消退，预计会有不同的电诊断结果。