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Master's Dissertation
DOI
10.11606/D.5.2003.tde-05092014-151831
Document
Author
Full name
Carlos Otto Heise
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2003
Supervisor
Committee
Gherpelli, José Luiz Dias (President)
Dias, Maria Joaquina Marques
Troster, Eduardo Juan
Title in Portuguese
Avaliação eletroneurográfica comparativa precoce de pacientes com plexopatia braquial obstétrica
Keywords in Portuguese
Eletromiografia/métodos
Lactente
Neuropatias do plexo braquial /fisiopatologia
Paralisia obstétrica/fisiopatologia
Prognóstico
Recém-nascido
Seguimentos
Traumatismo do nascimento/complicações
Abstract in Portuguese
O desenvolvimento de um método eficiente de avaliação prognóstica precoce seria de grande utilidade na seleção de lactentes com plexopatia braquial obstétrica para cirurgias de reconstrução do plexo braquial. Realizamos uma eletroneurografia bilateral em 33 bebês com plexopatia braquial obstétrica entre 10 e 60 dias de vida. Foram avaliadas e comparadas lado a lado as amplitudes dos potenciais de ação musculares compostos dos nervos axilar, musculocutâneo, radial proximal, radial distal, mediano e ulnar. Os bebês foram seguidos clinicamente até os seis meses de vida, quando foram submetidos a uma avaliação da força de vários grupos musculares e a uma prova funcional. Uma redução da amplitude do potencial de ação muscular composto em qualquer nervo do membro acometido maior ou igual a 90% da amplitude do potencial do membro sadio correlacionou-se com um resultado clínico ruim aos seis meses de idade (p < 0,01). A acurácia prognóstica da eletroneurografia foi de 91% para as lesões do tronco superior, 97% para as lesões do tronco médio e 100% para as lesões do tronco inferior. Nossos resultados indicam que a eletroneurografia parece ser um instrumento útil na avaliação prognóstica precoce de pacientes com plexopatia braquial obstétrica
Title in English
Electroneurography for early prognostic assessment of obstetrical brachial plexopathy
Keywords in English
Birth injuries
Brachial plexus neuropathies/physiophatology
Electromiography/methods
Follow-up studies
Infant
Infant newborn
Obstretric paralysis/physiopathology
Prognosis
Abstract in English
Early prognostic assessment of obstetric brachial plexopathies would be a major step for rational selection of infants for brachial plexus surgery. We performed bilateral electroneurography of Axillary, Musculocutaneous, proximal Radial, distal Radial, Median and Ulnar nerves in 33 babies (age 10 - 60 days) with obstetrical brachial plexus lesions in order to compare the amplitude of compound muscle action potentials (CMAPs). The babies were followed up for six months and the outcome was classified according to muscle power score and functional performance. A CMAP amplitude reduction in any nerve of the injured side superior or equal to 90% of CMAP amplitude of the normal side was related to an unfavorable clinical result at age of six months (p < 0,01). The prognostic accuracy of electroneurography was 91% for the upper trunk, 97% for the middle trunk and 100% for the lower trunk. Our results indicate that electroneurography seems to be a useful tool for very early prognostic assessment of obstetric brachial plexopathies
 
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Publishing Date
2014-09-08
 
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