CPP stands for Childish plexus paresis. Infantile plexus palsy is arm paralysis that affects newborns. It is caused by overstretching, tearing or tearing of nerve roots at birth. In addition to physiotherapy and ergotherapy, microconstructive measures can restore the mobility and sensitivity of the affected arm in the first few months of life, with intensive parental care also playing a role as a therapeutic measure.
What is childhood plexus palsy?
Plexus paresis is treated with various therapies or with surgery. There are no further complications. However, it cannot be predicted whether there will be a positive course of the disease. See AbbreviationFinder for abbreviations related to Childish plexus paresis.
In medicine, infantile plexus paresis is an infantile paralysis of the arm that occurs during birth as a result of an injury to the nerve plexus. Infantile arm paralysis varies in severity and restricts arm movement to varying degrees.
At the same time, there is a more or less severe disturbance of arm sensitivity. Depending on the number of nerve roots affected, achildish Plexus palsy either resolves or involves permanent limitation of movement.
Causes
The cause of infantile arm paralysis is always damage to the arm nerve structure that occurs during the birth process. As a rule, the damage is caused by an abnormal stretching of the arm nerves and is usually associated with complications during the birth process.
Such complications occur, for example, when the child’s shoulder gets caught and the obstetrician has to exert extreme pressure on the baby’s neck. However, mechanical obstetrics such as forceps can also promote childhood plexus paresis. Children with a birth weight over 4000 grams are most commonly affected.
Emergency situations such as wrapping the umbilical cord during childbirth can also require an impact on the neck and neck area and are therefore just as often associated with infantile arm paralysis. More rarely, the damage to the arm is due to a cesarean section or a nerve root tear during a breech birth.
Symptoms, Ailments & Signs
The brachial plexus is above the collarbone and has five nerve roots to three nerve trunks. In addition to the shoulder movement, the flexion and extension of the elbow is also controlled. This nerve complex is also responsible for hand movement and chest muscle movement. Depending on which of the five nerve roots are affected by the paresis, there is an upper, middle or complete plexus palsy.
The severity and location of the damage determine the symptoms. In the case of a complete plexus palsy with nerve root avulsion, the child cannot move the arm and chest muscle. Sensations are also no longer available for these areas. If there is only a tear or an overstretching instead of a tear, the ability to move and also the sensitivity of the corresponding areas is limited but not completely blocked.
In an upper plexus palsy, not all five nerve roots are affected. In this case, the sensitivity and restriction of movement only relates to the shoulder and the elbow area, with partial involvement of the pectoral muscles. A medium plexus palsy, on the other hand, only affects the pectoral muscle and the extension of the elbow.
Diagnosis & course of disease
The doctor can often diagnose a child’s plexus palsy by looking at it. This is especially true if the birth process was accompanied by complications that typically favor the appearance. To confirm the diagnosis, the doctor may arrange for appropriate imaging.
How a child’s plexus paralysis develops depends on the individual case and the number and intensity of the injuries. The corrective measures taken also influence the course of the disease. If, for example, microsurgical nerve reconstruction can take place, a more positive course can be assumed under certain circumstances. If growth disorders of the arm occur alongside the paresis, this indicates a more serious course of the disease with permanent damage.
In individual cases, negative factors can also be concomitant diseases such as being overweight. Under certain circumstances, the paralysis can lead to extreme malpositions in the affected arm, which are accompanied by joint wear and tear. In order to avoid such a course of the disease, physiotherapeutic measures can be helpful.
Complications
Affected children usually suffer from paralysis of their arms. This paralysis can lead to various limitations in the patient’s everyday life and thus to delayed development. The quality of life of those affected is significantly reduced by this disease.
In many cases, the parents and relatives are also severely affected by this disease and need psychological support. As a rule, stretching and bending the arm is no longer easily possible, which often puts strain on the shoulder. It is not uncommon for paresthesia and other sensory disturbances to occur in the damaged areas.
The patients can no longer carry out certain things and activities in everyday life. In many cases, the child’s plexus paresis also leads to growth disorders, which can lead to consequential damage and complications in adulthood. The arms can also assume a misaligned position and be put under even more strain as a result.
Plexus paresis is treated with various therapies or with surgery. There are no further complications. However, it cannot be predicted whether there will be a positive course of the disease.
When should you go to the doctor?
If the newborn can no longer move the arm and pectoral muscles properly, it may be due to childhood plexus palsy. A doctor should be consulted if the discomfort has not gone away after a day or the child shows signs of pain. If the child cannot straighten or bend their arm at all, they should go to the hospital immediately. Prompt intervention is also required when other symptoms add to the limitations in movement. Signs of paralysis, skin changes or behavioral problems in the child must always be examined by a doctor.
The child’s plexus paresis is often recognized immediately after birth and treated in the hospital. Further visits to the doctor are indicated during and after the therapy. In general, arm paralysis has to be treated over many years in order to permanently maintain and, in the best case, even improve arm mobility. The parents and later those affected themselves should therefore consult the doctor regularly. In addition to the family doctor, an orthopedist or a physiotherapist can be consulted. In addition, mother-child therapy is recommended.
Treatment & Therapy
Treatment for infantile arm palsy is highly dependent on which nerves are affected. In the first two weeks after birth, the arm is rested and immobilized, as the nervous system may recover from minor damage such as overstretching. Swelling and bruising should subside during this period.
Ergotherapeutic and physiotherapeutic measures are only initiated after these first few days, which are intended in particular to avoid a misalignment of the joints and are tailored to the movements of the child that are typical for their age. In individual cases, part of the nerves can also be restored in the early phase by means of a microsurgical intervention. As a rule, this reconstructive intervention takes place in the first few months of life.
For example, neurolysis removes any remaining scars, thereby improving the conductivity of the damaged nerves. Around three years after this procedure, the general functionality of the arm can be improved by relocating the tendons and muscles. The care of the parents is of great importance within the framework of all therapy measures. For example, an excessive burden on the mother-child relationship through the appearance should be avoided.
Outlook & Forecast
The prognosis of childhood plexus paresis is difficult to predict. Specific tests are needed to determine which nerves were affected or damaged when the newborn was born. In the case of a large number of patients, a complete recovery can be documented with good medical care and comprehensive care by the parents in the further course.
There are various therapeutic approaches and targeted training that can be used to achieve healing. Nevertheless, there is also the possibility that paralysis or partial paralysis will remain for life despite all efforts. The extent of the damaged nerve fibers provides information about the further course of the disease.
If the mobility of the arm is not restored, further sequelae can be expected. The immobility can lead to emotional and mental states of stress. If the course of the disease is unfavorable, mental disorders develop that contribute to a significant deterioration in well-being and quality of life. Physical performance is limited due to the disease and can lead to a severe weakening of the psyche. Everyday life must be restructured and adapted to the physical conditions of the patient. Depending on the individual personality traits and the environment of the patient, the risk of a mental illness is given.
Prevention
Parents can prevent infantile plexus paralysis as much as possible by entrusting the birth exclusively to experienced obstetricians. However, in the case of extreme birth complications, paralysis can occur even if the obstetrician has a lot of experience.
Aftercare
Those affected with this disease usually have very few options for aftercare. Treatment must be initiated immediately so that the child does not suffer permanent damage that could negatively affect the child’s life. In the worst case, permanent paralysis occurs that can no longer be treated.
The parents are dependent on the intensive care of the child and must support it. Physiotherapy measures are primarily necessary to alleviate the symptoms, and many of the exercises can also be repeated at home. The child also needs the help of their own family and friends in their everyday life.
If it develops further, further surgical interventions may be necessary to permanently relieve the symptoms. After such a procedure, the child should definitely rest and relax. No physical activities or exertion should be carried out. The disease also does not reduce the life expectancy of the child, provided it is treated quickly and correctly.
You can do that yourself
In the case of a child’s plexus paresis, long-term physiotherapeutic treatment is absolutely advisable. As part of the physiotherapy, the parents of affected patients are shown various exercises that they have to do several times a day with their children at home. Since infantile arm paralysis leads to physical limitations in everyday life, kindergartens, schools, training centers and workplaces must be proactively informed about the problem.
Sporting activities, especially swimming, can have a positive effect on plexus paralysis and should be encouraged if the child is interested. Some swimming clubs offer special courses for children with movement disorders. Parents should openly discuss infantile arm paralysis with their children. Dealing openly with the movement disorder, depending on the character and age of the child, is an important factor in self-help.
Negative or pejorative-sounding terms for the affected limb, such as a weak or broken arm, should be avoided. Talking to older children and adolescents about their own body image is of the utmost importance, because their own body image often changes with the onset of puberty. If the child blocks or withdraws completely, additional psychological or psychotherapeutic treatment of the patient with the aim of increasing self-esteem is recommended.
