Congenital symmetrical weakness of the upper limbs resembling brachial plexus palsy: a possible sequel of drug toxicity in first trimester of pregnancy?
We report a 14-month-old girl with a symmetrical paralysis from birth, limited to the upper limbs and resembling a severe, complete bilateral brachial plexus palsy. The presence of dimples over the wrists, shoulders and scapulae and abnormal palmar dermatoglyphics suggested an early prenatal onset. Previous reports and the course of the disease in our case suggest this sporadic condition is not progressive. Although no definitive causative factor has been identified in previously reported cases, the affection in our case is possibly related to Debendox (Bendectin) and nitrofurantoin taken in early pregnancy for nausea and renal tract infection, respectively.
Philpot
J
J
Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital, London, U.K.
Muntoni
F
F
Skellett
S
S
Dubowitz
V
V
D017668:Age of Onset; D000932:Antiemetics / Q000009:adverse effects*; D001132:Arm / Q000503:physiopathology*; D003878:Dermatoglyphics; D003937:Diagnosis, Differential; D004025:Dicyclomine; D004319:Doxylamine / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D009325:Nausea / Q000188:drug therapy; D009582:Nitrofurantoin / Q000009:adverse effects*; D010243:Paralysis / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011261:Pregnancy Trimester, First; D011736:Pyridoxine / Q000009:adverse effects*; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis*; D014552:Urinary Tract Infections / Q000188:drug therapy
D000932:Antiemetics; D004338:Drug Combinations; C004454:dicyclomine, doxylamine, pyridoxine drug combination; D004025:Dicyclomine; D009582:Nitrofurantoin; D004319:Doxylamine; D011736:Pyridoxine