. Medical and surgical therapy. ffect aroot distribution, and occupy a transverse band alongthe outer border of the arm, the forearm, and hand inthe area of the fifth and sixth cervical roots (fig. 56). They take the form of hypsesthesia to pricking,anaesthesia to slight touch, and often anaesthesia tocold, but more particularly to heat. In the early stages this sensory disturbance seemsto be so great that some patients complain that theycannot feel their arm at all, and even go so far asto look for it in their bed, although there is no accom-panying lesion of the cervical cord. These sensory
. Medical and surgical therapy. ffect aroot distribution, and occupy a transverse band alongthe outer border of the arm, the forearm, and hand inthe area of the fifth and sixth cervical roots (fig. 56). They take the form of hypsesthesia to pricking,anaesthesia to slight touch, and often anaesthesia tocold, but more particularly to heat. In the early stages this sensory disturbance seemsto be so great that some patients complain that theycannot feel their arm at all, and even go so far asto look for it in their bed, although there is no accom-panying lesion of the cervical cord. These sensory symptoms soon improve ; but asthe lesion disappears, pins and needles and burn-ing sensations over the whole area affected by hyp-aesthesia, but principally in the thumb and indexfinger, are complained of. Reflexes.—The reflexes are affected. The stylo- CERVICAL AND BRACHIAL PLEXUSES 133 radial reflex causes no contraction of the biceps,supinator longus, or deltoid muscles. Percussion of the styloid process of the radius, in-. FlG. 56.—Sensory radicular distribution of the upper limb (ventralaspect on the left, dorsal aspect on the right), stead of causing normal flexion of the forearm,produces a more or less energetic flexion of thefingers. 134 CLINICAL FORMS OF NERVE LESIONS The triceps reflex is normal and sometimes brisk. The scapula reflex produces no contraction of thedeltoid or of the supra- and infraspinati, and fre-quently, too, contraction of the pectoralis major isabsent. Idiomuscular contraction, which is generally strongin all the muscles, becomes slow at last in the anteriorsegment of the arm, deltoid, and supra- and infra-spinati. Recovery.—Recovery of the power of movementbegins in a few months, for in this upper root form,as in most of the lesions of the brachial plexus and itsroots, there is a remarkable tendency to a completeor partial disappearance of motor and sensory dis-turbances. The biceps and brachialis anticus seem to regaintheir functional acti
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