Brachial Plexus Palsy
Joe Hing Kwok Chu
Brachial: of the arm
Plexus: the group of five strands of nerves: C5, C6, C7, C8 and T1.
Palsy: paralysis or partial paralysis
to an infant during vaginal deliveries, especially when the babies are big.The shoulders get obstructed during the delivery and usually the injury happens on only one side.
The type of injuries are usually classified into four conditions:
1. Avulsion: the nerve is torn from the spine and it is the most severe type of damage.
2. Rupture: the nerve is torn but not at the spine.
3. Neuroma: the damaged nerve has tried to heal, and scar tissue has formed around the damaged nerve, obstructing or slowing the signals to reach the muscles.
4. Neuropraxia: (stretch): the nerve is damaged but not torn.
Prognosis: The recovery rate of neuropraxia is high. Different opinions on the recovery rates were reported from different sources ranging from 35% to 95%.
The detailed lab tests usually are performed before surgeries. The injured nerves can evolve between the period of the lab tests (CT, MRI and Nerve Conduction Velocity tests) and the surgeries, so they are usually not performed until the child is ready for surgeries. Delaying the tests is usually recommended if other injuries have been ruled out.
Wai qi can be applied to prevent scar tissue from forming and to speed up healing process.
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