Electromyographic Studies of Obstetrical Palsy

ABSTRACT

Electromyography and related electrodiagnostic techniques are being applied to clinical studies of neuromuscular diseases with increasing frequency and effectiveness. Four patients with obstetrical palsy were examined and followed up with electromyography. The findings from clinical observation and electromyographic studies were discussed in regard to the site of the lesion, prediction of prognosis and the degree of nerve regeneration. It is emphasized that findings provided by electromyographic examinations can not only contribute to accurate diagnosis, but also serve as a guide for selecting appropriate means of treatment with physical therapy for the patients with obstetrical palsy as well as to monitor progress, by doing a series of periodic examinations. Adler and Patterson(1967) reported that the incidence of Erb's palsy has remarkably decreased. From 1939 to 1962 they found only one hundred and twenty three cases instead of four hundred and ninety one cases in the period from 1928 to 1939 at the Hospital for Special Surgery. Statistics on obstetrical palsy due to the brachial plexus injury are not available in Korea. It is assumed however that its incidence here must also be decreased as the obstetric services have advanced significantly in recent years. The clinical picture of a brachial plexus palsy is dependent on the location of the pathology in the plexus and it is not easy to predict the prognosis without knowledge of the degree of injury. With electromyographic studies it is possible to detect the exact site of the lesion in the brachial plexus, the degree of injury and the progress of nerve regeneration. Therefore, it is a useful tool for making accurate diagnosis and prognosis and the findings provided by the electromyographic studies permit appropriate selection of treatment as the nerve regeneration takes place. Four cases of obstetrical palsy of the brachial plexus were referred to Severance Hospital for electromyographic examination and subsequent treatment from February to September 1972.