Sensory Deficits in Neonatal Brachial Plexus Palsy: A Cross-Sectional Study of Clinical, Electrophysiological, and
Ruth Van der Looven1, Ella Staelens2, Lothar Vanhoorebeeck2
1Department of Rehabilitation Sciences, Ghent University, Ghent; Child Rehabilitation Centre, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent.
Objective:
To systematically assess tactile sensibility in children with right-sided neonatal brachial plexus palsy (NBPP) using a standardized approach, and to investigate whether (1) sensibility is reduced in the affected, nondominant hand compared with the nondominant hand of matched controls, (2) sensory thresholds correlate with electrophysiological findings (ie, sensory nerve action potential [SNAP]), and (3) diminished sensibility in digits 1-3 is associated with impaired hand motor performance.
Design:
Cross-sectional study with a control group.
Setting:
Tertiary university hospital NBPP care unit.
Participants:
A total of 76 left-hand-dominant children aged 6-23 years: 31 with right-sided NBPP and 45 age- and sex-matched typical developing controls.
Interventions:
All participants underwent Semmes-Weinstein monofilament (SWM) sensory testing and motor assessment (Bruininks-Oseretsky Test of Motor Proficiency Second Edition and Purdue Pegboard Test). Participants with NBPP also underwent electrodiagnostic examination of SNAP.
Results:
Participants NBPP demonstrated significantly impaired tactile sensibility in digits 1-5 of the affected hand compared with typical developing controls (p=.006-.040). Sensory thresholds in digits 2-5 were also significantly worse than in the contralateral hand. Although SNAP abnormalities increased with lesion severity, SWM and SNAP results were only weakly correlated (φ=-0.325 to +0.110), highlighting the complementary nature of perceptual and electrophysiological testing. Within the NBPP group, reduced tactile sensibility in digits 1-3 was significantly associated with lower scores on the Bruininks-Oseretsky Test of Motor Proficiency Second Edition manual dexterity subscale (β=-0.302, p=.030) and the Purdue Pegboard Test (β=-0.309, p=.015).
Conclusions:
Tactile sensory deficits are prevalent in children with right-sided NBPP and are functionally relevant, as reduced sensibility in digits 1-3 is associated with impaired fine motor performance. The partial dissociation between the perceptual and electrophysiological findings highlights the complexity of sensory involvement and underscores the need for multimodal assessment. These results advocate routine sensory evaluation to guide early neurorehabilitation and inform long-term management in NBPP.
