Decreased Movement of the Upper or Lower Limb in the Neonate

Abstract

Decreased spontaneous movement of a limb in a neonate is to be taken seriously as urgent intervention may be needed in some instances (Waseem et al. 2009). The two reasons for reduction in spontaneous movements are paralysis and pain, and it is the latter that should invoke a sense of urgency in the treating physician. Pain arising from the limb manifests as pseudoparalysis, and the two most common causes are birth trauma (Lam et al. 2002; Matsubara et al. 2008; Morris et al. 2002; Cebesoy et al. 2009; Nakazato et al. 2001; Jacobsen et al. 2009; Lindseth and Rosene 1971; Journeau et al. 2001) and osteoarticular infection (Bulbul et al. 2009; Dessi et al. 2008; Frederiksen et al. 1993). The commonest cause of paralysis in the newborn is obstetric brachial plexus palsy; rarer palsies have been reported in the literature (al-Qattan et al. 1996; Hayman et al. 1999; Goetz 2010). Occasionally, birth palsy may be associated with birth trauma (Journeau et al. 2001) and very rarely with osteoarticular infection (Estienne et al. 2005).