Differential diagnosis of flaccid palsy of the upper extremities in children first months after birth (Literature review)

Abstract

This article analyzes the literature related to flaccid paresis and paralysis of the upper extremities in children during the first months of life. This pathology is a heterogeneous group of diseases with different etiopathogenesis. There are various courses of flaccid paresis and paralysis of the upper extremities in children: damage to the spinal cord, brachial plexus, peripheral nervous system to the level of the brachial plexus, and isolated damage to peripheral nerves. According to the time of occurrence, flaccid paresis and paralysis can be divided into three groups: antenatal, intranatal, and postnatal pathology. The main mechanism of occurrence of this pathology is intranatal trauma. More rare causes of flaccid paresis and paralysis of the upper extremities are antenatal conditions of dysplastic and traumatic origin, postnatal damage to the peripheral nervous system due to trauma or infection. Congenital contractures of the upper extremities combined with flaccid paralysis are connected with genetically determined diseases of the lower motor neurons and congenital myopathies, intrauterine injuries of the brachial plexus peripheral nerves. This article discusses the issues of topical and differential diagnosis of this pathology, the clinical picture suitable for each period of the child’s life, and the prognosis of the disease. This research will be useful not only for neurologists, but also for specialists of related specialties: orthopedists, physiotherapists, and neonatologists for making correct the diagnosis, providing adequate treatment, and predicting its results.