Neonatal Brachial Plexus Palsy occurs at a rate of about 1/1000 live births and should be suspected with asymmetric arm movements that persist at the time of discharge from the newborn nursery/NICU. Patients are managed by a combination of pediatricians, family practitioners, neurologists, therapists, neurosurgeons, and orthopaedic surgeons. Pediatric patients may be referred for unnecessary and invasive testing (MRI requiring anesthesia, nerve conduction studies), and they may not undergo recommended testing (Xrays to rule out diaphragm palsy or concomitant fracture). While almost all patients “recover” to some degree, this may not occur to a clinically useful or optimized extent. There is a window of time roughly between ages 6-12 months, during which microsurgical exploration and plexus reconstruction may benefit these patients.
