Isolated radial nerve lesion in the newborn

Area of Science:

• Neurology
• Pediatric Neurology
• Nerve Injury

Background:

• Radial nerve lesions are uncommon in newborns.
• Differentiating radial nerve injuries from brachial plexus injuries is crucial for prognosis.

Observation:

• Two newborns presented with isolated radial nerve lesions confirmed by electromyography.
• One infant showed early signs of nerve damage (fibrillation potentials) at 6 days old, suggesting prenatal onset.
• Skin necrosis near the radial nerve and triceps muscle indicated a possible entrapment mechanism, potentially linked to the umbilical cord.

Findings:

• Electromyography confirmed isolated radial nerve lesions in both infants.
• Evidence suggests a possible in utero onset for these radial nerve injuries.
• Complete clinical resolution was observed in both cases within a 4-month period.

Implications:

• This study highlights a specific type of neonatal radial nerve injury that resolves spontaneously.
• Early identification and differentiation from medial brachial plexus lesions are vital for appropriate management and parental counseling.
• Understanding potential causes like umbilical cord entrapment can inform preventative strategies.