Many child neurologists around the country recently received a mailing from members of the Miami Children's Hospital Brachial Plexus Program that included a recent review article on the management of neonatal brachial plexus palsy (NBPP).1 The article summarized the Miami center's approach to microneurosurgical treatment of selected children with NBPP, described secondary orthopedic reconstruction procedures in a subset of patients who underwent primary nerve repair, and reviewed the ancillary therapeutic options used in patients with NBPP (eg, rehabilitation techniques, neuromuscular electrical stimulation, and utilization of botulinum toxin injections for shoulder contractures). While we generally applaud this comprehensive approach to managing children with NBPP, there is ample room for healthy debate and skepticism about specific aspects of this approach.
Sparagana SP, Ezaki M. Microneurosurgery for Neonatal Brachial Plexus PalsyThe Need for More Information. Arch Neurol. 2006;63(7):1033-1034. doi:10.1001/archneur.63.7.1033