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Phrenic nerve palsy associated with brachial plexus avulsion in a pediatric patient with multitrauma

Pakize Karaoğlu1, Uluç Yiş, Ibrahim Öztura

  • 1Department of Pediatric Neurology, Dokuz Eylul University Medical School, Izmir, Turkey. pakizekaraoglu@gmail.com

Pediatric Emergency Care
|August 9, 2013
PubMed

Insights

Pediatric brachial plexus avulsion from trauma is rare. This case highlights a severe, overlooked unilateral phrenic nerve palsy causing respiratory distress in a child with brachial plexus injury.

Area of Science:

  • Pediatric Traumatology
  • Neurology
  • Respiratory Medicine

Background:

  • Brachial plexus injuries are common in adult multitrauma but rare in children.
  • Motor vehicle accidents and pedestrian strikes are leading causes of pediatric brachial plexus palsy.
  • Associated phrenic nerve palsy occurs in 10-20% of brachial plexus trauma cases, often asymptomatic unilaterally.

Observation:

  • A rare pediatric case of severe unilateral phrenic nerve palsy with respiratory distress.
  • The injury was associated with brachial plexus avulsion resulting from multitrauma.
  • This highlights a potentially overlooked complication in pediatric trauma patients.

Findings:

  • Severe unilateral phrenic nerve palsy can occur with brachial plexus avulsion in children.
  • Respiratory distress may be the presenting symptom of this rare complication.
  • Prompt recognition is crucial for appropriate management.

Implications:

  • Emphasizes the need for heightened awareness of phrenic nerve involvement in pediatric brachial plexus injuries.
  • Suggests respiratory evaluation should be considered in pediatric multitrauma with suspected brachial plexus injury.
  • Underscores the rarity and potential severity of combined brachial plexus and phrenic nerve avulsion in children.

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