Brachial Plexus Program Diagnosis and Treatment

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Contact the Brachial Plexus Program

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How is brachial plexus birth palsy diagnosed?

Brachial plexus birth palsy can be diagnosed by your baby’s pediatrician upon a thorough medical history and physical examination. Since the majority of babies with a brachial plexus injury recover in the first month to six weeks of life, these exams can be scheduled with a primary care doctor. Children who continue to have problems beyond six weeks should be seen by an orthopedist or brachial plexus specialist.

In addition to a physical exam, doctors may perform special imaging studies, like an MRI or nerve conduction studies. These tests are not as reliable for babies as for adults, and they require anesthesia. If accompanying fractures are suspected, doctors may take an x-ray. It’s important to find an experienced doctor who will be able to track your child’s progress over repeated exams.

A close-up view of the parts of the nerves within the brachial plexus

Once my child is diagnosed with brachial plexus birth palsy, how soon should we see a specialist?

Once your child’s pediatrician has made a diagnosis, it’s safe to wait up to four weeks for a comprehensive evaluation by an orthopedist or specialist.

How often should my child be seen/observed by her orthopedist after her initial appointment?

How often your child should be observed depends on her return of function. Typically, she may need to be seen every one to three months until she is 6 months old, then every six months through the time she’s 24 to 36 months old.

How is brachial plexus birth palsy treated?

Our brachial plexus team has developed innovative non-surgical and surgical treatments for children with all degrees of severity of brachial plexus birth palsy.


   •    Most brachial plexus birth palsies will heal on their own. Your doctor will monitor your child closely.
   •    Many children improve or recover by the time they’re 3 to 12 months old. During this time, ongoing exams
        should be performed to monitor progress.

Physical and/or occupational therapy

   •    Therapy is recommended to help maximize use of the affected arm and prevent tightening of the muscles
        and joints. It is important to work to prevent shoulder dislocation and/or deformity.
   •    With the teaching and guidance of therapists, parents learn how to perform range of motion (ROM)
        exercises at home with their child several times a day. These exercises are important to keep the joints and
        muscles moving as normally as possible. 

Botox injections: may be used (mainly for the shoulder) to:

   •    Help with therapy to maintain full joint motion
   •    Rebalance muscles
   •    Prevent contractures and shoulder dislocations


Children who continue to have problems after they’re 3 to 6 months old may benefit from one of several surgical options. Learn more about these surgical options.

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944