P14.3

Clinical Causes: Difficult or prolonged labor, especially when the baby’s shoulder gets stuck behind the mother’s pelvic bone (shoulder dystocia). Use of excessive force or obstetric maneuvers to deliver the infant, which can strain the baby's neck and shoulder nerves. Large birth weight (macrosomia), increasing the risk of nerve stretching or compression during delivery. Abnormal fetal positioning, such as breech presentation or face presentation, which can make delivery more complex. Premature birth, which sometimes involves less-developed nerves that are more susceptible to injury.

Key Symptoms: Weakness or paralysis in parts of the arm or hand, usually on one side. Loss of sensation or numbness in affected areas. Limited or abnormal movement of the shoulder, arm, or fingers. Flaccid or limp appearance of the limb on affected side. Lack of reflexes in the arm or hand. In severe cases, muscle wasting or atrophy over time. Pain or discomfort in the shoulder or arm, especially during movement.

Diagnosis Path: Electromyography (EMG) to assess the electrical activity of muscles. Imaging tests like MRI or ultrasound to visualize nerve damage or swelling. Observation of spontaneous movements and reaction to stimuli to evaluate nerve function. Assessment of the baby’s overall physical health and birth history to identify potential causes.

Treatment Protocols: Physical therapy to improve muscle strength, flexibility, and range of motion. Occupational therapy to help the child develop fine motor skills. Pain management strategies if discomfort is present. Surgical intervention in some cases, such as nerve grafts or nerve transfers, especially if spontaneous recovery doesn’t occur within the first few months. Regular monitoring and follow-up to track progress and adjust therapy plans as needed.