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Self-biting behavior in patients with neonatal brachial plexus palsy

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Abstract

Purpose

Self-biting behavior in patients with neonatal brachial plexus palsy (NBPP) has been associated with finger amputation. Our objective is to describe the incidence of this complication, risk factors, and clinical management.

Methods

We retrospectively analyzed 612 patients with NBPP. There were 303 males and 309 females. 51.8% of patients had C5-C6 lesions, 28.9% had C5-C7, 18.9% had C5-T1, and 0.3 had C7-T1 involvement.

Results

We identified 15 patients with self-biting behavior (2.5%). Ten patients had C5-T1 lesions, and five had C5-C7 lesions. Eight patents were submitted to brachial plexus surgery and seven were not. This behavior appeared between 8 and 46 months of life (mean 23.5), and it was always temporary. There was no difference between operated and non-operated patients (p > 0.05), and no correlation between age at surgery and age of appearance of self-biting behavior (p > 0.05). Physical restriction was effective in treating this complication and we had no case of finger amputation.

Conclusion

Self-biting behavior is a rare complication of NBPP, and it is usually associated with severe motor involvement. The behavior duration is limited to a few months. This condition can be effectively treated with physical restriction to prevent hand biting.

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Authors and Affiliations

Authors

Contributions

COH, RSM, and MGS submitted the project. COH, MZ, and HSN reviewed patient data. COH, MZ, and RSM wrote the main manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Carlos Otto Heise.

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Competing interests

The authors declare no competing interests.

Ethics approval

Ethical approval was waived by the local Ethics Committee of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. The study was conducted in accordance with the declaration of Helsinki.

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Parents provided consent for the picture publication as long as the identity of the patient remains confident.

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There is no competing interest from any of the authors for this publication.

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Heise, C.O., Zaccariotto, M., Martins, R.S. et al. Self-biting behavior in patients with neonatal brachial plexus palsy. Childs Nerv Syst 38, 1773–1776 (2022). https://doi.org/10.1007/s00381-022-05574-9

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  • DOI: https://doi.org/10.1007/s00381-022-05574-9

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