Saadet ARSAN, Serdar ALAN, Ufuk ÇAKIR, Atila KILIÇ, Begüm ATASAY, Ömer ERDEVE

Solunum semptomları ile tanı alan brakiyal pleksus paralizisine eşlik eden frenik sinir paralizisi

Brakiyal pleksus zedelenmesi doğum sırasında brakiyal pleksusdaki gerilmeye bağlı oluşur. Bozulan üst ekstremite motor fonksiyonları sıklıkla düzelir. Yenidoğanda brakiyal pleksus felci frenik sinir paralizisi ile eş zamanlı olabilir. Makat geliş, neonatal makrozomi, maternal diyabet, forseps/vakum kullanımı ve omuz distosisi belli başlı risk faktörleri olarak tanımlanır. Burada makrozomik doğup uzayan solunum sıkıntısı nedeniyle Erb- Duchenne paralizisine eşlik eden diafragma paralizisi tanısı alan olgu sunulacaktır.

Phrenic nerve palsy associated with brachial plexus palsy diagnosed with respiratory symptoms

After labor brachial plexus injury is caused by traction of brachial plexus. Frequently, upper extremity motor functions which were impaired, improves. Brachial plexus palsy and phrenic nerve palsy may be concurrent in newborns. Breech presentation, macrosomia, maternal diabetes, forceps/vacuum extraction, shoulder dystocia are known main risk factors. We present here, a macrosomic case who had prolonged respiratory distress and diagnosed Erb-Duchenne paralysis with diaphragmatic paralysis.

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1. Zafeiriou DI, Psychogiou K. Obstetrical brachial plexus palsy. Pediatr Neurol. 2008;38(4):235-42.
2. Gordon M, Rich H, Deutschberger J, Green M. The immediate and long-term outcome of obstetric birth trauma. I. Brachial plexus paralysis. Am J Obstet Gynecol. 1973;117(1):51-6.
3. Michelow BJ, Clarke HM, Curtis CG, Zuker RM, Seifu Y, Andrews DF. The natural history of obstetrical brachial plexus palsy. Plast Reconstr Surg. 1994;93(4):675-80.
4. Bowerson M, Nelson VS, Yang LJ. Diaphragmatic paralysis associated with neonatal brachial plexus palsy. Pediatr Neurol. 2010;42(3):234-6.
5. Pollack RN, Buchman AS, Yaffe H, Divon MY. Obstetrical brachial palsy: pathogenesis, risk factors, and prevention. Clin Obstet Gynecol 2000;43(2):236-46.
6. Stramrood CA, Blok CA, van der Zee DC, Gerards LJ. Neonatal phrenic nerve injury due to traumatic delivery. J Perinat Med 2009;37(3):293-6.
7. 7. Al-Qattan MM, Clarke HM, Curtis CG. The prognostic value of concurrent phrenic nerve palsy in newborn children with Erbs palsy. J Hand Surg Br. 1998;23(2):225.
8. Al-Qattan MM. Obstetric brachial plexus palsy associated with breech delivery. Ann Plast Surg. 2003;51(3):257-64.
9. Rouse DJ, Owen J. Prophylactic cesarean delivery for fetal macrosomia diagnosed by means of ultrasonography-a Faustian bargain? Am J Obstet Gynecol 1999;181(2):332-8.
10. Ozdemir R, Oğuz S, Uras N, Erdeve O, Yilmaz Y, Ulu H, Dilmen U. Phrenic nerve injury due to thoracentesis for TPN effusion in a preterm newborn: consecutive two unusual complications. Tuberk Toraks. 2011;59(4):384-7.
11. Lemmer J, Stiller B, Heise G, et al. Postoperative phrenic nerve palsy: Early clinical implications and management. Intensive Care Med 2006;32(8):1227-33.