Background

Publications regarding the epidemiology and management of brachial plexus birth injury (BPBI) were evaluated to investigate treatment guidelines for children with BPBI.

Methods

A search of neurology literature from 1990 to 2019 was performed using PubMed, Scopus, and Medline. Data including incidence, risk factors, spontaneous recovery rates, imaging studies, treatment recommendations, and indications and timing for surgery were collected.

Results

A total of 46 total studies were reviewed. Reported incidence rates for BPBI ranged from 0.3 to 3 per 1000 births. Spontaneous recovery rates had an average reported range from 66% to 75%. Physical and occupational therapy were recommended in 37% of articles. Computed tomographic myelogram and magnetic resonance imaging of the brachial plexus were the most commonly recommended imaging studies for BPBI. Timelines for surgical interventions ranged from age three to nine months. Early referral was recommended in 28% of the articles included in the review.

Conclusions

Given the inconsistencies in spontaneous recovery rates, imaging recommendations, and timing of referral, establishing consistent clinical guidelines for patients with BPBI is crucial for management. Early referral to specialists for evaluation and treatment may improve outcomes in children with BPBI.

中文翻译：

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臂丛产伤：评估变异性和当前建议的神经病学文献综述

背景

评估了有关臂丛神经分娩损伤 (BPBI) 的流行病学和管理的出版物，以研究 BPBI 儿童的治疗指南。

方法

使用 PubMed、Scopus 和 Medline 检索了 1990 年至 2019 年的神经病学文献。收集的数据包括发病率、危险因素、自然恢复率、影像学研究、治疗建议以及手术的适应症和时机。

结果

共审查了 46 项研究。报告的 BPBI 发病率为每 1000 例新生儿 0.3 至 3 例。自发恢复率的平均报告范围为 66% 至 75%。37% 的文章推荐物理和职业治疗。臂丛神经的计算机断层扫描脊髓造影和磁共振成像是最常推荐的 BPBI 影像学检查。手术干预的时间表从 3 个月到 9 个月不等。28% 的评论文章建议早期转诊。

结论

鉴于自发恢复率、影像学建议和转诊时间的不一致，为 BPBI 患者建立一致的临床指南对于管理至关重要。早期转诊给专家进行评估和治疗可能会改善 BPBI 儿童的预后。