Perinatal Brachial Plexus Palsy

Question 1

Define perinatal brachial plexus palsy

Answer 1

Flassid paralysis of the arm at birth affecting nerves of th ebrachial plexus supplied by C5 to T1

Question 2

What is the incidence of perinatal brachial plexus palsy?

Answer 2

0.42-5.1 infants per 1000 live births

Question 3

What is the most common cause of PBPP?

Answer 3

• Birth trauma
• But some evidence suggests that it can happen before delivery

Question 4

What is PBPP associated with?

Answer 4

• Shoulder dystocia
• Maternal diabetes
• Instrumental delivery
• Infants LGA
• No proven causative correlations

Question 5

What is the best management for PBPP?

Answer 5

• No RCTs compare surgical versus conservative management
• Non randomized studies show that kids with severe injuries do better with surgical repair

Question 6

What is the natural history of PBPP?

Answer 6

• 75% infants recover completely within the first month of life
• 25% experience permanent impairment and disability
• If PE shows incomplete recovery by 3-4 weeks, full recovery is unlikely

Question 7

Compare primary and secondary surgical intervention for PBPP

Answer 7

• Secondary soft tissue and bone reconstructive surgery may improve function in children with significant impairment but is inferior to primary intervention