Clinical staging optimized for obstetric paralysis recovery prediction.
Newborn Nerve Probe
Categorize obstetric brachial plexus injuries based on neonatal physical examination to determine the path for spontaneous recovery or surgical explorations.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Early infantile evaluation (usually at 2-4 weeks of age) of shoulder dystocia related brachial plexus injuries.
Setting parental expectations regarding spontaneous recovery versus the need for microneurosurgical repair at 3-6 months.
Section 2
Literature
Development
Developed by Dr. Algimantas Narakas in 1987. He systematically codified the physical exam findings of hundreds of infants to demonstrate that the distribution of paralysis (upper trunk vs pan-plexus) and the presence of sympathetic disruption (Horner's) strongly predicted whether the injury was a reversible stretch (neuropraxia) or a catastrophic root avulsion.
Section 3
Pearls/Pitfalls
Horner Syndrome
The presence of Horner syndrome reliably indicates avulsion of the T1 root directly from the spinal cord, because the sympathetic fibers exit through T1. Root avulsions CANNOT heal spontaneously and necessitate early surgical management (nerve transfers).
