Science News: Tactile Perception of the Hand in Children With an Upper Neonatal Brachial Plexus Palsy

Published January 30, 2024

Science News

Submitted by: Rebecca O’Bryan, MD
Edited by: Nandita Keole, MD

Citation: Buitenhuis SM, Pondaag W, Wolterbeek R, Malessy MJA. Tactile perception of the hand in children with an upper neonatal brachial Plexus palsy. Arch Phys Med Rehabil. 2023;104(6):872-877. doi:10.1016/j.apmr.2022.11.010

Summary: The aim of this study was to investigate sensory deficits that cause impairment of hand function in children between 7-12 years with an upper neonatal brachial plexus palsy (NBPP). This was a cross sectional study comparing 41 children with upper NBPP in non-dominant hand with 25 healthy controls (mean ages approximately 10 yo). All children had normal hand motor function as evaluated by routine clinical examination. A monofilament was used to assess sensation in the fingertips along the radial and ulnar sides. The ability to localize stimuli on the tips of the fingers in children with an upper NBPP was significantly diminished in all fingers, except for the little finger, as compared with healthy controls. Mean localization scores were 6.6 (thumb) and 6.3 (index finger) in the NBPP group and 7.6 in both fingers for controls (maximum score possible is 8.0). Localization scores were significant lower in regions attributed to dermatomes C6 (P=0.115)

Comments: This article focuses on hand function in children affected with upper trunk BP, and notes that decreased sensation in all but the 5th digit persists and may affect hand function. They suggest sensory focused therapy for these children to improve their functional status. Outcome focus in upper trunk brachial plexopathy is usually on the proximal motor function, which can be severely affected in these children, but care should be taken not to ignore sensation deficits that may involve the hand as well.