Brachial plexopathy associated with alcohol intoxication is rarely reported. We describe two patients with injuries to the brachial plexus thought to be the result of either stretch or compression of the plexus while intoxicated. In the first patient, damage was bilateral affecting the entire plexus on the right and the upper plexus on the left. This patient had associated rhabdomyolysis due to direct alcohol myotoxicity or prolonged immobilisation. In the second patient damage was on the right, involving predominantly the upper trunk. Neurophysiological studies and the rapid and complete recovery in our patients suggest that the primary pathology was focal demyelination causing conduction block, although there was also EMG evidence of axonal degeneration, particularly in the right arm of the first patient, in whom recovery was consequently delayed. Injury to the brachial plexus should be considered in patients with upper limb deficits related to intoxication.

The association between brachial plexopathy and both anaesthesia and intoxication is well recognised but this condition has been rarely described resulting from alcohol. We describe two patients with injuries to the brachial plexus who underwent neurophysiological studies, one with unilateral and the other with bilateral damage arising from prolonged immobilisation associated with alcohol intoxication. One patient had associated rhabdomyolysis due to either direct alcohol myotoxicity, prolonged immobilisation on a hard surface, or a combination of the two.

The first patient was an obese 69 year old man who lived on his own and drank at least two litres of vodka (900 g alcohol) a week. He returned from a party where he had drunk a large quantity of alcohol and fell next to his bed but did not lose consciousness. He was unable to get onto his bed and slept on the floor. The next morning he woke with profound weakness and sensory loss in …