Neonatal brachial plexus palsy : Early diagnosis and treatment

Abstract

The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi­d­ual’s quality of life is endangered. To provide better chan­ces to BPP neonates and infants, the Department of Developmental Neurology worked out, introduced, and applied a complex early therapy, including nerve point stimulation. After diagnosing the severity of BPP, early intensive and complex therapy should be started. Appro­x­imately after a week or ten days following birth, the slightest form (neurapraxia) normalizes without any intervention, and signs of recovery can be detected around this period. The therapy includes the unipolar nerve point electro-stimulation and the regular application of those elemen­tary sensorimotor patterns, which activate both extremities simultaneously. With the guideline worked out and applied in the Department of Developmental Neurology, full recovery can be achieved in 50% of the patients, and even in the most severe cases (nerve root lesion), functional upper limb usage can be detected with typically developing body-scheme. Immediately starting complex treatment based on early diagnosis alters the outcome of BPP, providing recovery in the majority of cases and enhancing the everyday arm function of those who only partially benefit from the early treatment.