Malik Sushma, Bhandekar Heena Sudhir, Korday Charusheela Sujit
Professor, Incharge Neonatology, Department of Pediatrics, TN Medical College & BYL Nair Hospital , Mumbai, India .
Senior Resident, Neonatology, Department of Pediatrics, TN Medical College & BYL Nair Hospital , Mumbai, India .
J Clin Diagn Res. 2014 Oct;8(10):PD10-2. doi: 10.7860/JCDR/2014/9205.5059. Epub 2014 Oct 20.
Traumatic peripheral nerve palsies in the newborn are uncommon but are a cause of severe anxiety in parents. Erb's palsy, brachial plexus, radial nerve and facial nerve are the common nerves affected. Perinatal injuries are the most frequent cause of traumatic peripheral neuropraxias / nerve palsies. Usually these neuropraxias are self-limited with good recovery with conservative management in majority of cases.Ten neonates with peripheral neuropraxias were included in this retrospective study based on a review of these cases over a period of three and a half years. Their clinical profile, presenting symptoms, predisposing factors and management were analyzed. We encountered five neonates with erb's palsy, three with facial palsy and two had radial nerve affection. Risk factors in our series included large babies, prolonged or difficult labour, instrumental delivery and shoulder dystocia. All cases of peripheral nerve involvement were managed conservatively with physiotherapy. Nine neonates were discharged and showed gradual improvement and one patient unfortunately succumbed due to severe birth asphyxia. Parental counseling and rehabilitation play an important part in management of these cases.
新生儿创伤性周围神经麻痹并不常见,但会让家长极为焦虑。臂丛神经麻痹、桡神经和面神经是常见的受累神经。围产期损伤是创伤性周围神经失用症/神经麻痹最常见的原因。通常,这些神经失用症具有自限性,大多数情况下通过保守治疗可实现良好恢复。基于对三年半时间里这些病例的回顾,本回顾性研究纳入了10例患有周围神经失用症的新生儿。分析了他们的临床特征、症状表现、诱发因素及治疗情况。我们遇到5例臂丛神经麻痹新生儿、3例面神经麻痹新生儿和2例桡神经受累新生儿。我们研究中的危险因素包括巨大儿、产程延长或难产、器械助产和肩难产。所有周围神经受累病例均采用物理治疗进行保守治疗。9例新生儿出院,病情逐渐好转,1例患儿不幸因严重出生窒息死亡。家长咨询和康复治疗在这些病例的管理中起着重要作用。