OBSTETRICAL BRACHIAL-PLEXUS PALSY (OBPP) OUTCOME WITH CONSERVATIVE MANAGEMENT

Resurgence of neurosurgical intervention oi obstetrical brachial plexu s palsy prompted our review of 186 patients evaluated between 1981 and 1993, correlating clinical examination, electrodiagnosis, and functio nal outcome with conservative management. Eighty-eight percent had upp er brachial plexus palsies, and 63% were mild. Forty-two infants requi red no long-term follow-up because they rated 1 or 2 on initial physic al examination, Comparing first and last follow-up clinical findings o f the remaining 149 patients, there was high agreement (correlation r = 0.81; P <0.001). Pearson correlation of initial physical exam with e lectrodiagnosis at three intervals was relatively stable (r = 0.87, 0. 88, 0.69). One hundred eight (72%) of the patients remained in their o riginal severity groups. Thirty-three of 41 patients with discrepant f ollow-up scores improved by at least one category. Eight patients dete riorated. The natural pathophysiology and recovery of OBPP is presente d. (C) 1996 John Wiley & Sons, Inc.