Neonatal Brachial Plexus Palsy: the role of diminished sensibility of the hand on functional recovery

Buitenhuis, S.M. (2024)

Doctoral Thesis

The aim of this thesis was to gain a better understanding of the deleterious effects of Neonatal Brachial Plexus Palsy (NBPP) on central development by analyzing sensory and motor function.
The explanation for problems with hand function was not clear in children who had an upper NBPP where only the C5 and C6 spinal nerves are affected, which predominantly innervate the shoulder and elbow flexion. 

The main findings of this thesis: 

Children with an upper NBPP have a diminished sensibility of the thumb and index finger which correlates with diminished dexterity. 

The ability to localize stimuli to the thumb, index, third and fourth fingers is disturbed in children with an upper NBPP. 

Most children with an upper NBPP are not aware of the diminished sensibility in their affected hand. Also Grip force of the hand is reduced in children with an upper NBPP lesion. 

NBPP is a peripheral nervous lesion, which affects the development of the central nervous system as well. The age at which children with NBPP can walk independently is delayed, which does not depend on the severity of the lesion. 

Treatment of children with a NBPP had to focus on the total development of the child.

• Diminished Sensibility
• Reduced Dexterity
• Gripforce
• Central Nervous System
• Dominant versus Affected Hand

• All authors: Buitenhuis, S.M.
• Supervisor: Malessy, M.A.
• Co-supervisor: Pondaag, W.
• Committee: Nelissen, R.G.H.H.; Gorter, J.W.; Engelbert, R.H.H.; Vliet Vlieland, T.P.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2024-06-11
• ISBN (print): 9789464734249