Obstetric Brachial Plexopathy

Brachial plexus birth palsy (BPBP) is a neurological injury in newborns during childbirth. There is a dysfunction of the upper limb nerves with a variable recovery rate. The severity varies depending on the number and location of damaged nerves. The diagnosis is based on medical history and a physical examination. Successful treatment begins with understanding the anatomy of the brachial plexus and the pathophysiology of nerve injury. BPBP classifications can guide the prognosis and the management as they are based on the extent and anatomy of nerve injury, as well as clinical presentation. Serial physical examinations and a thorough clinical history form the basis of the treatment plan that relies upon occupational/physical therapy but may include nerve reconstruction and secondary musculoskeletal surgeries. The affected infants have an overall optimistic prognosis, with the majority recovering adequate use of the affected arm. The rate of spontaneous recovery ranges between 75% and 90%. Of importance is an early referral to interdisciplinary clinics and acquiring awareness of the psychosocial and quality-of-life problems that surround cases of chronic disablement of BPBP.