Obstetrical brachial plexus palsy: lessons in functional neuroanatomy.
Obstetrical branchial plexus paralysis is a serious and possibly disabling disorder. While thoroughly described as a clinical entity, much concerning its pathogenesis is still unknown. Basic science studies alongside with studies on functional neuroanatomy of peripheral and central nervous system and their interactions lead to deeper understanding of its pathology. Research concentrates on the consequences of branchial plexus traction to peripheral nerves and muscles function and viability and rehabilitation options. Changes obstetrical branchial plexus paralysis causes to central nervous systems organisation have been, to some extent, investigated. It seems that central nervous system is not "blind" after obstetrical branchial plexus paralysis but instead proceeds to remodelling so to adapt to new needs. Research indicates that both this entity and organism's response are much more complicated than previously believed. Current treatment options include microsurgery and palliative surgery but their improvement is possible by focusing on central nervous system. Current report discusses these topics and tries to reach useful conclusions.
Department of Anatomy, University of Athens, School of Medicine, Greece. Electronic address: elizabethojohnson@gmail.com.
Elizabeth O
EO
Johnson
Department of Anatomy, University of Athens, School of Medicine, Greece.
Theodore
T
Troupis
Department of Anatomy, University of Athens, School of Medicine, Greece.
Adamantios
A
Michalinos
Department of Anatomy, University of Athens, School of Medicine, Greece.
John
J
Dimovelis
Orthopaedic Research & Education Center, Attikon University Hospital, Athens, Greece. Electronic address: psoukakos@ath.forthnet.gr.
Panayotis N
PN
Soucacos
D001917:Brachial Plexus / Q000293:injuries / Q000503:physiopathology*; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D019091:Critical Pathways; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008866:Microsurgery; D010246:Paralysis, Obstetric / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D010525:Peripheral Nerves / Q000503:physiopathology; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology* / Q000601:surgery; D013484:Supination; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology* / Q000601:surgery; D000092464:Elbow Injuries