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Obstetrical lesions of the brachial plexus. Natural history in 34 personal cases
Insights
Obstetrical brachial plexus palsy significantly impacts daily activities, especially in total or lower plexus paresis cases. However, most children achieve functional recovery and maintain a good quality of life.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Obstetrics
Background:
- Obstetrical brachial plexus palsy is a significant birth injury.
- Early diagnosis and intervention are crucial for optimal outcomes.
Purpose of the Study:
- To evaluate the long-term functional outcomes and quality of life in children with obstetrical brachial plexus palsy.
- To assess the impact of different types of paresis and treatments on recovery.
Main Methods:
- Retrospective study of 34 subjects diagnosed with obstetrical brachial plexus palsy.
- Follow-up assessment of functional deficits and quality of life.
- Analysis of physiotherapy and electrotherapy interventions.
Main Results:
- Significant motor deficits were observed in severe cases, impacting daily activities.
- No clear correlation was found between physiotherapy/electrotherapy and treatment outcomes.
- Most subjects, even with serious sequelae, reported a good quality of life and self-image.
- Early improvement was noted within the first three years of life.
Conclusions:
- Obstetrical brachial plexus palsy can lead to long-term motor deficits, but functional recovery is generally favorable.
- Quality of life and self-image appear resilient despite significant physical impairments.
- Further research may explore optimal therapeutic strategies beyond conventional physiotherapy.
Abstract:
34 subjects with 36 obstetrical paralysis of the brachial plexus were studied. The diagnosis was made immediately after birth in the great majority. 5 pareses of the lower plexus, however, were only recognized later. All subjects were first seen by us under the age of 13 years, 25 during the first year of life. At follow-up the age of the 34 subjects varied between 3 and 24 years. 32 patients had undergone daily physiotherapy, in 5 electrotherapy had also been applied. There was no correlation between these treatments and the outcome. Of the 20 cases of paresis of the lower plexus 3 were severely handicapped after the age of 3. This was the case for 9 of the 12 patients with total paresis. Everyday activities of these patients are influenced by the motor deficit. Even subjects with relatively serious sequelae apparently enjoy an almost normal life and have a good self-image. A significant improvement generally occurred as early as the first 3 years of life.