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Published on: December 19, 2019
A Systematic Review of the Electrodiagnostic Assessment of Neonatal Brachial Plexus
Virginia Orozco1, Sriram Balasubramanian1, Anita Singh2
1Drexel University, School of Biomedical Engineering, Science and Health Systems, Philadelphia, Pennsylvania, USA.
Insights
Neonatal brachial plexus palsy affects 1-4 infants per 1000 births. This review details electrodiagnostic techniques for assessing these injuries and their prognostic value.
Area of Science:
- Neurology
- Pediatrics
- Obstetrics
Background:
- Neonatal brachial plexus palsy (NBPP) affects 1-4 per 1000 live births globally.
- While most infants recover spontaneously, 20-30% experience permanent functional deficits.
- The brachial plexus's complex anatomy leads to varied injury patterns.
Purpose of the Study:
- To comprehensively review electrodiagnostic techniques for assessing NBPP.
- To highlight the role of these techniques in differentiating lesion types and providing prognosis.
Main Methods:
- Review of existing literature on electrodiagnostic methods for NBPP.
- Focus on nerve conduction studies (motor and sensory) and electromyography.
- Analysis of how these techniques assess signal changes and conduction.
Main Results:
- Electrodiagnostic studies are crucial for diagnosing NBPP.
- These methods help distinguish between axonal and demyelinating lesions.
- Findings correlate with prognosis for functional recovery.
Conclusions:
- Electrodiagnostic techniques are essential for managing NBPP.
- Accurate assessment aids in predicting long-term outcomes.
- Further research can refine these diagnostic tools.
Abstract:
Despite improvements in obstetric care, neonatal brachial plexus palsy continues to significantly impact infants' lives worldwide, with an incidence of 1 to 4 per 1000 live births. While a majority of affected infants recover spontaneously by three months, 20-30% suffer permanent functional deficits that significantly impair their quality of life. Anatomical complexity of the brachial plexus results in varying degrees of injury and pathological changes at multiple levels within the plexus. Current clinical diagnosis relies on electrodiagnostic techniques such as nerve conduction (i.e., motor and sensory) and electromyography studies. These techniques not only aid clinicians to differentiate between axonal and demyelinating lesions, evident by changes in signal shape and conduction, but also provide prognostic information in cases of brachial plexus injuries. The presented study offers a comprehensive review of existing literature on electrodiagnostic techniques employed for assessing neonatal brachial plexus injuries.
