Pediatric Brachial Plexus and Peripheral Nerve Center

The brain and spinal cord continually transmit and receive information to and from the rest of the body through a complex network of peripheral nerves which send signals outward to muscles and receive incoming signals from the senses. That is why functions such as muscle strength or sensory perception can be lost if a nerve is injured. The brachial plexus is a specific network of peripheral nerves located in the neck that extend from the spinal cord to and from the shoulder, arms, and hands. Modern neuroscience has discovered that injured peripheral nerves can regenerate and reconnect if they are provided with a pathway that directs the nerve’s regrowth to its proper point of reconnection. For this reason, there are neurosurgical and rehabilitative therapy techniques which can often lead to restoration of lost function after a nerve injury has occurred. For this reason, the New Jersey Pediatric Neuroscience Institute has established a collaborative, team-approach, multidisciplinary center of excellence for the diagnosis and treatment of brachial plexus and other peripheral nerve injuries which occur in newborns, infants, and children, and adolescents.

The pediatric neurosurgeons, neurologists, plastic surgeon, and physiatrist of the New Jersey Pediatric Neuroscience Institute have partnered with an outstanding pediatric therapy group with pediatric occupation therapists and physical therapists highly skilled in evaluation and treatment of infants, children and adolescents. We all work together as a cooperative multispecialty team which provides comprehensive diagnosis and effective treatment of brachial plexus and peripheral nerve injuries or other types of peripheral nerve dysfunctions.

When an infant, child, or teen-ager has a suspected brachial plexus or peripheral nerve injury, the care that our Brachial Plexus and Peripheral Nerve Center provides begins with an initial diagnostic evaluation. That will include appropriate examinations by experts of different specialties. Depending on the child’s condition, several of the following experts may be involved in the child’s care: pediatric neurosurgeon, pediatric neurologist, pediatric physiatrist, pediatric plastic surgeon, pediatric occupational therapist, and/or pediatric physical therapist. The different specialists, who are involved in the child’s evaluation, will review all the examination findings together and collaborate to make the most accurate determination of which specific nerves are injured and precisely in what locations are the nerves injured.

The team of experts will also provide follow up evaluations over several months to determine which injured nerves are spontaneously recovering and to identify whether any specific nerves are failing to heal. If natural nerve healing fails to occur, then the team will again collaborate to determine whether a specific state-of the art type of nerve operation can be performed that will enable restoration of the lost nerve function. That type of nerve microsurgery would then be offered to the parents with full disclosure of the predicted benefits and possible risks. If authorized, microsurgical nerve operation would be performed by a pediatric neurosurgeon and a pediatric plastic surgeon working together in the operating room.

Regardless of whether a surgical treatment is or is not performed, physical and occupational therapies, guided by the expertise of the pediatric physiatrist,
will be provided to help the patient to achieve the best possible functional outcome.