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Neonatal brachial plexus palsy - early diagnosis and treatment
Marianne Berényi1, Márta Szeredai1, Ágnes Cseh1
1Department of Developmental Neurology, St. Margaret Hospital, Budapest.
Insights
Early, complex therapy, including nerve point stimulation, significantly improves outcomes for brachial plexus palsy (BPP) in infants. This approach enhances arm function and recovery for most affected neonates and infants.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Brachial plexus palsy (BPP) incidence is decreasing, but quality of life remains a concern.
- Early intervention is crucial for improving outcomes in affected neonates and infants.
Purpose of the Study:
- To introduce and evaluate a complex early therapy for brachial plexus palsy (BPP).
- To enhance recovery chances and functional outcomes for infants with BPP.
Main Methods:
- Diagnosis of BPP severity followed by intensive, complex therapy.
- Therapy includes unipolar nerve point electro-stimulation and sensorimotor pattern activation.
- Treatment initiated within the first week or ten days of life.
Main Results:
- Full recovery achieved in 50% of patients.
- Functional upper limb usage observed even in severe nerve root lesion cases.
- Improved body scheme development noted.
Conclusions:
- Immediate complex treatment based on early diagnosis significantly alters BPP outcomes.
- The therapy leads to recovery in the majority of cases.
- Enhances everyday arm function for patients with partial recovery.
Background And Purpose:
The incidence of brachial plexus palsy (BPP) has decreased recently, but the indivi-d-ual's quality of life is endangered. To provide better chan-ces to BPP neonates and infants, the Department of Developmental Neurology worked out, introduced, and applied a complex early therapy, including nerve point stimulation.
Methods:
After diagnosing the severity of BPP, early intensive and complex therapy should be started. Appro-x-imately 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 elemen-tary sensorimotor patterns, which activate both extremities simultaneously.
Results:
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.
Conclusion:
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.
