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October 1982

Intrapartum Brachial Plexus Injury

Author Affiliations

Department of Neurology Beth Israel Hospital Boston, MA 02215

Arch Neurol. 1982;39(10):673-674. doi:10.1001/archneur.1982.00510220071026

To the Editor.—  Brachial plexus injuries may follow head injury, shoulder girdle trauma, hyperabduction of an anesthetized patient's arm, or prolonged external compression.1 We report an unusual cause in an awake patient.

Report of a Case.—  A 27-year-old woman was eight months pregnant when she noted spontaneous rupture of membranes and onset of labor. Throughout the two-hour delivery she remained supine, with both hands clutching the mattress baseboard behind her head. Her arms were hyperabducted and externally rotated at the shoulders and flexed at the elbows, and her neck was flexed. After local perineal anesthesia, she was delivered of a healthy girl. Fifteen minutes after delivery of the placenta, she became aware of left arm weakness. Twelve hours later, there was weakness against resistence of the left deltoid, teres major, supinator, triceps, and wrist and finger extensors. The left triceps jerk was absent. All other muscle groups and reflexes

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