United Brachial Plexus Network, Inc.

Hi, I'm new to this board. My daughter was born with a LOBI just 3 weeks ago today. I'm still trying to deal with this injury and learn everything.

She had an EMG yesterday. Although the doctor was encouraged to see some recruitment in the biceps, her results were not very good. I believe he said her biceps were about 20% and 5% in the deltoid and I think triceps. There was no recruitment in the deltoid. The only good news was that he said there were no avulsions.

I was just wondering if there is any possiblity of recovery without surgery with results like this. The doctor seemed to say that most of the times results like this will mean surgery, but did say there is still a possiblity.

We will be meeting Dr. Nath at the BPI picnic next week, but I just wanted to see if anyone else has had experience with recovery after a poor EMG?

Hi Michelle...

I'm not sure what your percentages mean and how they relate to what I'm about to tell you... but when I read your post (and email) I thought of Maia's primary surgery.

They went in and found a large neuroma. A neuroma is where she has her ruptures - 3 nerves were partially ruptured and there was a neuroma that covered all 3 nerves. They did intraoperative testing and found that she needed 3 nerve grafts. The way it was explained to me is that whatever is dead they cut away and whatever is alive, they leave. If the intraoperative EMG shows less than 50% then they graft and if it's more than 50% then they leave it alone.

So my question is because I don't know how they do a regular EMG versus an intraoperative EMG.... what do your percentages mean in comparison with my percentages? I guess it's a question to ask Dr. Nath next weekend.

see you next weekend!
-francine

Hi Francine,

My name is Dani, and I have a 10 week old son with BPI injury to his right arm.

What movements did your daughter have when she was 10 weeks old?

Just trying to get as much info. from as many different people as I can.

Thanks!!

hello Dani
my son is now almost 12 years old ( I can hardly believe it!) and he has a robpi
When he was 10 weeks old he had some finger movement and a little bit of a shrug in the shoulder, but he had no biceps (elbow bend) at all.
He stayed the same really and at 6 months he had a nerve graft surgery.
When they looked inside they discovered that he had 3 severed nerves and two stretched nerves.
They succesfully grafted the severed nerves using a donor nerve from his leg and then the slow process of
recovery began.
After about 12 months post operatively he could bend his elbow and bring his hand to his mouth and up to the top of his head.
He's had a couple more surgeries since, to deal with some muscle contractures but he is such an active boy and is constantly trying out new hobbies and activities.
He copes extremely well in school and has never had any additional support in any of his classes.
he is a helpful boy, always the first one to offer to do a job for you and he takes care of the younger kids in school.He is a whizz on the playstation and x box console and is about to start taking drum lessons
( not sure thats a good idea though!)
I hope this will offer yu a little reassurance about your little one.

My son had a EMG when he was 2 months old and there was little to no response. The neurologist, who was strongly against surgery, saying he didn't think it worked told us our best bet was to actually look into surgery. He had no bicep, deltoid or tricep at that time, and very little finger movement. He had primary surgery at 5 months old. He will be 3 years old on Sat., and he brings his hand to mouth, over his head, behind his head. He uses it very well. I will say the best thing that could of happened and what got us through was Francine Litz. You found this board and are in touch with Dr. Nath. You are in very good hands. Dr. Nath did my son's first surgery and is doing his next one. I wouldn't go anywhere else. I hope that your child doesn't have to have surgery, but if that is what happens, just know you are in good hands. You have people who care and who are here to help anytime.
Kelly

My sonb Brandon is 5 years old with a right BPI. When he was 4 months he had a EMG with no response at all....he didn't even cry because he couldn't feel a thing in the affected arm...so off to TCH we went to see the "miracle worker" Dr. Nath. Brandon had nothing at 7 months. He didn't even feel an ice cube in his hand at 7 months. He had primary at 7 months and Mod Quad at 14 months....he was one of the youngest if not he youngest to have Mod quad back then, now they do it earlier. We had outstanding results from both surgerys. Although I would say, we saw the most from the Mod although in my opinion I think that he was getting primary recovery very close to the same time his splint came off. WE actaully moved to Texas to be closer to those fine facilities....it may not be for everyone, but I loved the specialized expertise in therapy we recieved. Even saw Dr. Nath spying in on occasion. Brandon now does everything like his bigger brother and sisters. We had family pistures taken the other day and he even put his right hand in his pocket....we were so happy. You are going to the best place in my opinion. Dr. Nath and friends are so wonderful. If your child needs surgery, she is in good hands. Brandon has had such great recovery that we thank the Lord everyday that we found those experts at TCH.....
Good Luck
Gayle
Mom of Brandon
5 year old with ROBPI

My daughter was born LOBI. She did not have movement in her arm until 3 months of age and went hand to mouth right before she was scheduled for surgery at TCH and she did NOT have to have surgery. We did ROM exercises at EVERY diaper change. Email me at shavav@yahoo.com and we can talk more.

Take care,
Shava

My daugher was just like yours. She got movement back at around 3 months of age and she went hand to mouth right before we left for TCH to have surgery (at 5 mo. old) and she did NOT have to have surgery once we got there. We did ROM exercises at every diaper change and it made the difference. Email me at shavav@yahoo.com and we can talk more.

Take care,
shava

My granddaughter was born 19 mo. ago with a lobpi. She had no movement in her arm. An EMG showed no bicep, deltoid, or triceps. She had primary surgery at TCH when she was 5 mo. old and at 11 mo. she had a 2nd EMG. This time the doctor (who talked against surgery) seemed very surprised to see that the EMG was showing enervation in biceps, triceps, and deltoid. She had the mod quad at 12 mo. of age, and this surgery showed amazing results. Before the mod quad, she could not lift her arm higher than her shoulder. Afterwards, she could lift it above her head. Even though the doctors in our area were against surgery (one doctor even told us right after her birth that there was no surgery for Erb's palsy), we are so glad her parents made the decision to go ahead with surgery. We feel that surgery accompanied by therapy has done wonders for our grandchild.

I just thought I'd post our experiences with movement.
Our son (RBPI) had NO arm movement, NO feeling, NO hand- NO wrist movement... nothing of the sort ...unitl he turned 5 months old, he twitched one day, day three opened and shut fist, day 7 (or so) feeling (i tested this by scratching him on the underneath of his arm) and by 6 months ...HAND TO MOUTH!!!
Now he is 2 1/2 and we are off to Texas for his first surgery.... (MOD).
Each child is so different! Nerves are a funny thing!