Son with Brachial Plexus Injury

My son was born on Sept 6, 2008 via c-section. During his first day, I was unaware he had any issue because he did all things newborns did--he suckled and did in his diaper. I did not notice that his right arm was in a flexed position at the elbow and his wrist was flexed outward because he was bundled up tightly in hospital fashion. When the duty pediatrician gave him his complete physical on day 2, this is when the Dr. noticed the problem.



The Dr. ordered x-rays to make sure there were no broken bones to explain the position of my son's arm. The x-rays came back negative for broken bones. This is when the Dr. requested my son be seen by the Shriner's Hospital in Montreal. At this point we were going on the hypothesis that our son had a brachial plexus injury. We had our appointment 10 days after.



At the Shriner's we met with a specialist and her team. We left the Shriner's without a diagnosis because our son did not present the classical signs of a brachial plexus injury; however, treatment began with the hypothesis that our son did have a brachial plexus injury. The specialist requested we consult with another Brachial Plexus specialist who would then recommend we consult with a neurologist should the need arise. We started with occupational therapy right then and there, and a splint for his wrist to be used at night to correctly position his wrist. At first the Occupational Therapy (OT) visits were every 3 weeks where the OT would teach me how to exercise his arm and what signs to watch for. Then the OT visits would be scheduled based on my son's development and hitting certain milestones.



After consulting with the other specialist, again the Dr. could not make a definitive diagnosis and so arranged for us to visit with the neurologist. At the neurologist visit, the Dr. thought that our son did not have a brachial plexus injury but prescribed a CT Scan to rule out a lesion on my baby's brain. The CT Scan came back negative.



So we were back to square one. What did our son have and what was the prognosis? Both Brachial Plexus specialists consulted with each other and recommended we take our son to their specialized clinic for Brachial Plexus Injury at Hopital Marie Enfant . During this visit our son was examined by both Brachial Plexus Injury Doctors plus a team of occupational therapists and physical therapists. Again our son did not present in the classical brachial plexus injury. The good news though was our son continued to make improvement. He could move his arm from the shoulder, he could move his elbow, there was slight movement in his wrist, and his thumb was no longer stuck under his other fingers. Only his 3rd or middle finger remained "stuck". The team at Marie Enfant recommended we see the neurologist again for an EMG.



At this second visit to the neurologist, my son was finally diagnosed with brachial plexus injury after the EMG in March. In all of the neurologist's experience, (he's in his late 50's or early 60's with grandkids the age of my son), he had never seen a case like my son's. The neurologist then ordered and MRI to localized which nerve is damaged. Because my son had continued to make progress, his prognosis is good according to the neurologist.



As for my son hitting his milestones, he was about 4 to 6 weeks late in holding his head. At 7 months if I leave him on the carpet, he is sure to end up at the other end of the room by rolling over. He is not crawling yet but tries to get to his knees when on his stomach. He is able to hold his bottle with his left hand and support it with his right. He is aware that his right hand exists as he sucks his right thumb almost exclusively. He uses his right hand as a helper for his left hand when he wants a toy.



Our OT visits are on a weekly basis because he is making so much progress. The current sign we need to watch for is with the elbow at 90 degrees can our son twist his wrist. YES he can, ever so slightly, but YES!!! This means that the nerve is working/healing from the shoulder to the wrist.