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The brachial plexus is a network of nerves which run from the cervical spinal cord to the muscles of the upper limb.
Brachial plexus birth palsy refers to an injury to these nerves sustained during childbirth. The nerves of the brachial plexus may be stretched, compressed, or torn. This may result in loss of muscle function and subsequent paralysis of the upper limb. Injuries may affect all or only a part of the brachial plexus, resulting in varying degrees of upper extremity involvement. Injuries to the upper brachial plexus (C5, C6) affect muscles of the shoulder and elbow, while injuries to the lower brachial plexus (C7, C8, and T1) can affect muscles of the forearm and hand.
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Brachial plexus birth palsies are often separated into different categories, depending upon the type of nerve injury and the pattern of nerves involved.
There are four different types of nerve injuries that may occur:
Terms used to describe different patterns of injury:
Brachial plexus birth palsies occur in approximately 1-3 out of every 1,000 live births. Risk factors for the development of brachial plexus birth palsy include: large gestational size, breech presentation, prolonged or difficult labor, vacuum- or forceps-assisted delivery, twin or multiple pregnancy, and a history of a prior delivery resulting in brachial plexus birth palsy.
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