Brachial Plexus Neuralgia in Newborns

　　Brachial plexus palsy in newborns is common in birth trauma, but it can also be seen in traction injury, confrontational injury, and compression injury.

　　1. Traction injury:Such as injury caused by the upper limb being pulled into a belt.

　　2. Confrontational injury:Such as impact to the shoulder or shoulder injury.

　　3. Compression injury:Such as clavicle fracture or compression of the shoulder acromial region.

　　4. Birth Trauma:Abnormal fetal position during delivery or injury caused by traction during labor, often due to factors such as difficult labor, breech presentation, and difficult shoulder delivery, which cause excessive traction and injury to the brachial plexus. It is more common in full-term and macrosomic infants.

　　Since brachial plexus palsy is caused by nerve trunk injury, the clinical complications and the location and severity of nerve injury are related. Mild cases may cause the child to cry and be unwilling to have others touch the affected limb due to abnormal sensations such as numbness and pricking of the muscle tissue. Severe nerve injury can cause muscle weakness, numbness, and other traumatic manifestations, which may lead to complications such as muscle atrophy over a long period of time.

　　Brachial plexus palsy in newborns is a common disease of birth trauma, and its clinical symptoms are divided into three types:

　　1. Brachial Type

　　Brachial plexus palsy in newborns, also known as Duchenne-Erb paralysis, is caused by the most susceptible damage to the fifth and sixth cervical nerve roots, hence this type is most common in clinical practice. The affected upper limb is droopy, adducted, unable to abduct and laterally rotate; the elbow joint shows the forearm adducted and extended, unable to supinate or flex; the wrist and finger joints of the child are flexed, and the grasp reflex is asymmetric.

　　2. Middle arm type

　　The middle arm type is characterized by injury to the C7 nerve root, paralysis of the muscles innervated by the radial nerve, loss or weakening of extension movements of the forearm, wrist, and hand, while the triceps brachii and thumb extensor muscles are incomplete paralysis.

　　3. Lower arm type

　　The lower arm type is characterized by involvement of the C8 to T1 nerve roots, weakness of the flexor muscles of the wrist and hand, and weakened grasp reflex. It is clinically rare. If the sympathetic nerve fibers of the first thoracic root are damaged, it can cause Horner syndrome, manifested as pupil constriction, eyelid narrowing, etc.

　　Shoulder dystocia and breech delivery are the main causes of brachial plexus neuralgia in newborns. Incorrect delivery methods are also an unignorable factor. Therefore, doing well in prenatal prediction and improving the quality of obstetrics is the key to preventing brachial plexus neuralgia in newborns. Strict obstetric operations should be carried out to avoid excessive traction on the brachial plexus.

　　Auxiliary examinations for brachial plexus neuralgia in newborns include magnetic resonance imaging and electromyography, etc. Magnetic resonance imaging can determine the lesion site of brachial plexus neuralgia in newborns, while electromyography examination and nerve conduction test are also helpful for diagnosis.

　　The diet of newborns with brachial plexus neuralgia has little effect on auxiliary treatment. It is best for the child to be breastfed. Breast milk is the most ideal natural food for infants aged 0 to 6 months. Breast milk is nutritionally comprehensive and proportionally reasonable. As long as breast milk is sufficient, it can fully meet the growth needs of infants at this stage. In particular, the essential fatty acids contained in breast milk can promote the development of infant brain cells.

　　Newborns with brachial plexus neuralgia should start with massage and passive exercises within the first week after birth. Most cases can improve and recover within 2-3 months after treatment. If there is nerve tear, permanent palsy may remain. Oral treatment with nerve nutrition drugs can also be considered, and appropriate physical therapy. As the child grows older and can cooperate, more active exercises should be practiced, and attention should be paid to observe changes in the condition in daily life.