Dr. Vinod Dubey

  • Kandivali | Malad | Mira Bhayandar | Thane
  • +91 8108127022 / 6358854077 / 8369338859
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OBPP and other neuromuscular palsy of upper and lower limb

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What is Obstetrical Brachial Plexus Palsy (OBPP)?

The brachial plexus is a network of nerves that run from the spinal cord, through the neck, to the arm. Brachial plexus birth injury refers to damage to the brachial plexus that occurs at birth, and may be related to a difficult labor and delivery.

Causes

During delivery of large babies, or smaller babies in breech presentation, the nerves of the brachial plexus may be stretched and injured. Some risk factors associated with brachial plexus birth injury include a long, difficult labor, a larger-than-normal infant, gestational diabetes, maternal obesity and breech presentation.

Symptoms

The symptoms can vary widely in severity based on the extent of the damage. There is incomplete sensory and motor function in the affected arm. The most common (and least severe) presentation is Erb’s palsy, in which the shoulder is internally rotated, the elbow extended, and the hand and wrist function normally.

The most severe presentation of brachial plexus birth injury, also known as global palsy, presents with complete paralysis of the affected arm, without function in the shoulder, elbow, forearm, wrist nor hand. There are intermediate presentations between Erb’s and global palsy.

Care

Initial evaluation of patients with brachial plexus birth injury should take place within the first 1-2 months of life, and it should be performed at a center that specializes in the care of brachial plexus injuries. Despite the fact that many cases will recover spontaneously, early therapy with a pediatric occupational/physical therapist is critical to prevent permanent joint deformities from developing. If spontaneous recovery does not occur, surgery may be required to repair or reconstruct the damaged nerves.

In the most severe cases, this type of operation may be considered as early as 3 months of age. As the child grow, surgery may be considered to improve weak muscles and correct joint deformities; usually tendon transfers and bone repositioning.

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FAQ'S

What is the basic knowledge of cardiology?

Cardiology is the medical specialty that deals with the diagnosis and treatment of diseases related to the heart and blood vessels. Basic knowledge of cardiology includes understanding the anatomy and function of the heart, the various cardiovascular diseases, risk factors for heart disease, diagnostic techniques such as electrocardiograms (ECGs) and echocardiograms, treatment options including medications, interventions, and surgeries, and preventive measures to maintain heart health.

What are some good questions to ask a cardiologist?
  • What lifestyle changes can I make to improve my heart health?
  • What are the risk factors for heart disease, and how can I manage them?
  • What symptoms should I be aware of that might indicate a heart problem?
  • What diagnostic tests might be necessary to assess my heart health?
  • What are the treatment options available for my specific condition?
  • Are there any potential side effects or risks associated with the prescribed medications?
  • How often should I have follow-up appointments to monitor my heart health?
  • Are there any specific dietary recommendations I should follow?
  • Can you provide information on cardiac rehabilitation programs?
  • What steps can I take to prevent future heart problems?
What Type of Cardiologist Should You See for Specialized Heart Care?
  1. The type of cardiologist you should see for specialized heart care depends on your specific condition. Here are a few examples:
  • Interventional Cardiologist: Specializes in performing procedures such as angioplasty, stenting, and catheter-based treatments for coronary artery disease and other structural heart problems.
  • Electrophysiologist: Focuses on the diagnosis and treatment of heart rhythm disorders (arrhythmias) using techniques like electrophysiology studies and cardiac ablation.
  • Heart Failure/Cardiomyopathy Specialist: Specializes in managing heart failure and cardiomyopathy, including the use of advanced therapies like implantable devices or heart transplantation.
  • Adult Congenital Heart Disease Specialist: Deals with the diagnosis and treatment of heart conditions that were present since birth but persist into adulthood.
  • Cardiovascular Surgeon: Performs surgical procedures on the heart and blood vessels, such as coronary artery bypass grafting, heart valve repair or replacement, and heart transplantation.
What are the different types of heart disease?
  1. Coronary artery disease (CAD): This is the most common type of heart disease and occurs when the coronary arteries, which supply blood to the heart, become narrow or blocked due to a buildup of plaque.
  2. Heart failure: This refers to a condition where the heart is unable to pump enough blood to meet the body’s needs. It can result from various underlying causes such as CAD, high blood pressure, or heart valve disease.
  3. Arrhythmias: These are abnormal heart rhythms that can occur due to electrical disturbances in the heart. They can cause the heart to beat too fast, too slow, or irregularly.
  4. Heart valve disease: This condition occurs when one or more of the heart valves do not function properly. It can involve valve stenosis (narrowing) or valve regurgitation (leakage).
  5. Cardiomyopathy: This refers to diseases of the heart muscle, where the muscle becomes thick, rigid, or weak, affecting the heart’s ability to pump effectively.
  6. Congenital heart disease: This is a type of heart disease that is present at birth. It involves structural defects in the heart that affect its normal function.
  7. Pericardial disease: This involves inflammation or abnormalities of the pericardium, the sac-like membrane surrounding the heart.
What are the common symptoms of heart disease?
  1. Chest pain or discomfort (angina): This is a common symptom of coronary artery disease. It may feel like pressure, tightness, or a squeezing sensation in the chest.
  2. Shortness of breath: Difficulty breathing or feeling breathless, especially with exertion or when lying flat, can be a sign of heart disease.
  3. Fatigue: Feeling excessively tired or lacking energy, even with minimal physical activity, may be a symptom of heart disease.
  4. Heart palpitations: Sensations of a rapid, fluttering, or pounding heartbeat may occur with certain heart conditions.
  5. Dizziness or fainting: Feeling lightheaded, dizzy, or actually fainting can be a result of inadequate blood flow to the brain due to heart problems.
  6. Swelling: Fluid retention can cause swelling in the legs, ankles, feet, or abdomen.
  7. Rapid weight gain: Sudden and unexplained weight gain may be a sign of fluid buildup related to heart failure.

It is important to note that these symptoms can also be caused by other conditions, and some individuals with heart disease may not experience any symptoms until a more advanced stage. If you are experiencing any concerning symptoms, it is recommended to consult a healthcare professional for a proper evaluation.