Denervation and reinnervation in congenital brachial palsy

Scarfone, Heidi; McComas, Alan J.; Pape, Karen E.; Newberry, Rebecca

doi:10.1002/(sici)1097-4598(199905)22:5<600::aid-mus8>3.0.co;2-b

Cited by 30 publications

(15 citation statements)

References 11 publications

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“…Attempts to eliminate this problem spawned several other MUNE methods, including multiple‐point stimulation, spike‐triggered averaging, and others . Other refinements focused on increased efficiency using automated and semi‐automated approaches to deliver incremental stimulation and measure waveform size …”

Section: Mune Methodsmentioning

confidence: 99%

Motor unit number estimation: A technology and literature review

et al. 2014

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Section: Mune Methodsmentioning

confidence: 99%

Motor unit number estimation: A technology and literature review

et al. 2014

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“…106 The mean number of motor units in biceps and thenar muscles was approximately 50% that of control arms in a study in children with obstetric plexopathy with a minimum age of 4 years. 84 MUP amplitudes were increased; the pattern was therefore that of severe loss of motor units of long standing. Eight children had normal numbers of motor units in the biceps muscle, in contrast to the significant upper arm and shoulder problems.…”

Section: Emg Findings: Possible Answersmentioning

confidence: 96%

“…The first is a permanent loss of function due to a closed window of opportunity to develop a motor program, as suggested earlier. 14,84 The other rests on the finding that central nervous system plasticity occurs in adult plexus lesions [55][56][57] ; the young nervous system appears capable of surprising amounts of plasticity and functional repair, so a central "solution," involving recruiting muscles for trick movements, is not unreasonable.…”

Section: Emg Findings: What Is the Solution?mentioning

confidence: 99%

Obstetric lesions of the brachial plexus

2001

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The few studies on prognosis of obstetric lesions of the brachial plexus that are not hampered by selection bias or a short follow-up suggest that functional impairment persists in 20-25% of cases, more than commonly thought. Electromyography (EMG), potentially useful for prognosis, is often considered of little value. Denervation in the first week of life has been interpreted as evidence of an antenatal lesion, but is the logical result of the short axonal length affected. EMG performed at close to the time of possible intervention (3 months) usually shows a discrepancy: motor unit potentials are seen in clinically paralyzed muscles. This can be explained in five ways: an overly pessimistic clinical examination; overestimation of EMG recruitment due to small muscle fibers; persistent fetal innervation; developmental apraxia; or misdirection, in which axons reach inappropriate muscles. Further research into the pathophysiology of obstetric lesions of the brachial plexus is needed to improve prognostication.

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“…Many children with this injury recover well with conservative or operative approaches; however, up to 15% have persistent severe deficits. A subgroup of these patients has demonstrable MUs on EMG, but persistently impaired motor skills using these reinnervated muscles 99. Experimental studies have suggested that this may be due to a developmental apraxia, with defective motor programming early in infancy 100 101…”

Section: Rehabilitation and Non-surgical Approachesmentioning

confidence: 99%