Hand Sensorimotor Function in Older Children With Neonatal Brachial Plexus Palsy.

Area of Science:

• Pediatric Neurology
• Neurorehabilitation
• Developmental Pediatrics

Background:

• Neonatal brachial plexus palsy (NBPP) assessment typically assumes sensory recovery exceeds motor recovery.
• Existing studies on sensory function in NBPP yield inconsistent results.
• Routine sensory assessments are often overlooked in NBPP management.

Purpose of the Study:

• To investigate hand sensorimotor function in older children diagnosed with NBPP.
• To evaluate tactile sensibility using established clinical and research measures.
• To compare tactile perception in children with NBPP to age-matched controls.

Main Methods:

• Seventeen children with NBPP (mean age 11.6 years) and 19 controls underwent functional assessments.
• Evaluations included grip force, monofilament testing, and hand dexterity (Nine-Hole Peg, Jebsen-Taylor Hand Function).
• Tactile spatial perception was assessed via pin pattern discrimination and object recognition (stereognosis).

Main Results:

• Children with NBPP showed significant motor deficits in the affected hand compared to the unaffected hand.
• Monofilament testing indicated normal tactile registration in both hands for the NBPP group.
• Impaired tactile spatial perception was evident in the NBPP group, affecting accuracy and speed of pattern/object recognition.

Conclusions:

• Tactile perception deficits can coexist with motor deficits in NBPP, even with normal basic touch sensitivity.
• These sensory impairments may stem from altered somatosensory feedback processing.
• Comprehensive sensory assessments, beyond basic tactile registration, are crucial for NBPP evaluation.