Neonatal Brachial Plexus Paralysis: A Discussion on the Light of Literature
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Resumo
Neonatal Brachial Plexus Paralysis (PPBN) is defined as a brachial plexus traction or compression injury resulting from dystocic delivery. The incidence of PPBN varies from 0.42 to 5.1% per 1000 births. The lesion occurs in the expulsive period of childbirth, is most often associated with shoulder dystocia, gestational or pre-gestational diabetes and macrosomic fetuses. The lesion resulting from C5-C6 root involvement is the most frequent, affecting around 50 to 60% of the cases, and 80% of these patients have spontaneous recovery. However, around 20 to 30% of patients may develop persistent deficits, with permanent impacts on upper limb function, compromising the child's development; leading to repercussions for their families and for the health system. PPBN is usually diagnosed by clinical examination and usually does not require imaging studies. Initial treatment is conservative based on functional rehabilitation through physical therapy. Sequential physical examination will indicate patients with no recovery of shoulder movement between 3 and 6 months, who may benefit from surgical treatment. The prognosis of PPBN depends on the level (pre- or postganglionic), the extent, severity of the lesion, the speed of recovery and the quality of initial clinical management.
Keywords: Obstetric Paralysis, Brachial plexus, Neonatal
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Referências
Abdouni, Y. A. et al. (2017). Relação entre a idade e o tipo de paralisia obstétrica do plexo braquial com o movimento de pronossupinacão do antebraço. Revista Brasileira de Ortopedia, 52 (5):596–600.
Abid, A. (2016). Brachial plexus birth palsy: Management during the first year of life. Orthopaedics & Traumatology: Surgery& Research 102, S125-S132.
Alvites, R. et al. (2018). Peripheral nerve injury and axonotmesis: State of the art and recent advances. Alvites et al., Cogent Medicine. 5: 1466404.
Annika, J.; Paul, U. And Anna-Lena, L. (2019). Obstetric brachial palsy- A prospective, population-based study of incidency, recovery and long-term residual impairment at 10 to 12 years of age. European Journal of Paediatric Neurology 23, 87-93.
Blaauw, G. and Muhlig, R. S. (2017). Brith Palsy ( Obstetric Brachial Plexus Palsy). Jornal of Neurology & Translational Neuroscience. 5(1): 1075.
Borges, André Varandas. (2016). Tratamento não Cirúrgico nas Lesões do Plexo Braquial. Dissertação de Mestrado Integrado em Medicina. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto.
Buterbaugh, K.L.; Shah, A.S. (2016). The natural history and management of brachial plexus birth palsy. Current Reviews in Musculoskeletal Medicine, 9:418-426.
Chauhan, S.P. Blackwell, S. B. and Anath, C.V. (2014). Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends. Seminar in Perynatology 38; 210-218.
Coroneos C. J; Voineskos S. H.; Christakis M. K. et al. (2017). Obstetrical brachial plexus injury (OBPI): Canada’s national clinical practice guideline. BMJ Open; 7:e 014141.
Heise, C. O.; Martins, R.; Siqueira, M. (2015). Neonatal brachial plexus palsy: a permanente challenge. Arquivos de Neuropsiquiatria; 73 (9): 803-808.
Kriukova, I.A. et al. (2016). Development of an algorithm for the treatment of children with brachial plexus birth palsy in the first mons of life. Ортопедия, травматология и восстановительная хирургия детского возраста. Том 4. Выпуск 1.
M. M. Al-Qattan et al. (2009). Narakas classification of obstetric plexus palsy revisited. The Journal of Hand Surgery (European Volume, 34E: 6: 788–791.
Raducha, Jeremy. E. et al. (2017). A review of Brachial Plexus Birth Palsy: Injury and Rehabilitation. Rhode Island Medical Journal, november, p.17-21
Smith, B.W. et al. (2018). Un Update on the Management of Neonatal Brachial Plexus Palsy- Replacing Old Paradigms. A review. JAMA Pediatrics, april 30.
Socolovsky, M. et al. (2016). Obstetric brachial plexus palsy: reviewing the literature comparing the results of primary versus secondary surgery. Child’s Nervous System. March, Volume 32, Issue 3, pp 415–425.
Wilson, T. J. (2018). Prediction for Surgical Intervencion in Neonatal Brachial Plexus Palsy. Neurosurgery; 82:335–342.
Yau, C.W.H.; et al. (2018). Obstetric brachial plexus injuries (OBPIs): health-related quality of life in affected adults and parentes. Health and Quality of Life Outcomes; 16:212.