Early Electrodiagnosis in the Management of Neonatal Brachial Plexus Palsy.

Van Der Looven, Ruth; Le Roy, Laura; Tanghe, Emma; Van Den Broeck, Christine; De Muynck, Martine; Vingerhoets, Guy; Pitt, Matthew; Vanderstraeten, Guy

Neonatal brachial plexus palsy (NBPP) is an important form of newborn morbidity with potentially disabling persistence. Neurosurgical intervention is indicated in selected patients. Early prognostic assessment would facilitate rational selection of those infants for surgery. We conducted a systematic literature review to determine the prognostic value of early electrodiagnosis (EDX) in NBPP. We included 16 observational studies with a total sample size of 747 children. Risk of bias and quality of evidence were rated. Wide variation was found in EDX techniques, outcome algorithms and decision making. Nevertheless, the most methodologically sound studies support the use of EDX, at standardized time frames, as key prognostic modality complementing clinical judgement and neuroimaging. An accurate knowledge of underlying anatomy of the nerve injury helps to counsel families and to guide reconstructive strategy. This article is protected by copyright. All rights reserved.