Sign Up for a Free Account
  • Updated 10.21.2020
  • Released 06.02.2003
  • Expires For CME 10.21.2023

Brachial plexus palsy in neonates

Introduction

Overview

Neonatal brachial plexus palsy can be a debilitating injury that leads to long-term disability in the infant. Although the majority of cases do recover full function of their arm, others must undergo surgery or other treatments to improve function. This article describes the pathology and anatomy of brachial plexus palsy, provides tips to examine an affected patient, and reviews the available treatment options.

Key points

• The most common brachial plexus palsy involves the upper roots, C5 and C6, and is called Erb palsy.

• The spontaneous recovery rate is 60%, and some children suffer permanent impairment.

• Surgical treatment is usually offered between 3 to 6 months of age for primary repair; otherwise, patients can undergo secondary procedures around 12 to 18 months of age.

• A multidisciplinary approach with the pediatrician, physical and occupational therapists, and the surgeon is very helpful when treating an infant with brachial plexus palsy.

Historical note and terminology

Neonates who have neurologic deficits have been observed since the time of the ancient Greeks and Hippocrates (64). Brachial plexus palsy related to the birth process, “obstetric brachial palsy,” was described by Scottish obstetrician William Smellie (1697–1763) in a textbook originally published in 1754 titled A sett of anatomical tables, with explanations, and an abridgment, of the practice of midwifery (131; 132; 133; 134; 92; 111; 124; 130).

William Smellie (1697–1763)
Scottish obstetrician William Smellie (1697–1763). Smellie described obstetrical brachial plexus palsy in 1654. Line engraving by R Anderson. (Courtesy of Wellcome Images and Wikimedia Commons. Creative Commons Attribution 4.0 Int...

German neurologist and neurophysiologist Wilhelm Heinrich Erb (1840–1921) first compared neonatal brachial plexus palsy with that found in adults and concluded that it involved the upper roots (154; 121).

Wilhelm Heinrich Erb (1840–1921)
German neurologist and neurophysiologist Wilhelm Heinrich Erb (1840–1921). Erb first compared neonatal brachial plexus palsy with that found in adults and concluded that it involved the upper roots. (Courtesy of the U.S. National ...

The term “Duchenne-Erb palsy” was coined because French neurologist Guillaume-Benjamin-Amand Duchenne (de Boulogne) (1806–1875) received credit for describing the brachial plexus palsy following delivery of affected newborns (40; 19; 117; 72; 56; 106; 118; 121).

Guillaume-Benjamin-Amand Duchenne (de Boulogne) (1806–1875)
French neurologist Guillaume-Benjamin-Amand Duchenne (de Boulogne) (1806–1875). Duchenne described the brachial plexus palsy following delivery of affected newborns. (Courtesy of Wikimedia Commons. Public domain.)

In addition, brachial plexus injury to the lower roots (C8-T1) was first described by American-born French neurologist Augusta Klumpke (1859–1927) in 1885 (78; Peltier 1999; 17; 18; 56; 127; 157; 44).

Augusta Klumpke (1859–1927)
American-born French neurologist Augusta Klumpke (1859–1927) (right) and her husband Jules Dejerine (1849–1917). (Courtesy of Wellcome Images and Wikimedia Commons. Creative Commons Attribution 4.0 International License.)

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, 
including video clips of 
neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of 
neurology in 1,200 
comprehensive articles.

Questions or Comment?

MedLink, LLC

10393 San Diego Mission Rd, Suite 120

San Diego, CA 92108-2134

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660

Support: service@medlink.com

Editor: editor@medlink.com