Acupuncture treatment of obstetric brachial palsy

Author

Introduction

The major causes of supraclavicular plexopathies are closed-traction injuries (including obstetric paralysis). The injure to the brachial plexus during birth is related several adverse obstetric factors such as macro-fetus, difficult labor, abnormal presentation and fetal distress. The paralysis is usually of the Erb-Duchenne type and is often transitory. Avulsion of the plexus may occur but is not common. Acupuncture and Moxibustion have been used for several years in the treatment of motor and sensorial disorders as those observed in plexopathies.

Case history

An 18-years-old male patient with palsy on left superior limb by obstetric injury, came to our hospital to receive the neurorestorative treatment program. He was sent to the Department of Traditional Chinese Medicine as part of the Center teamwork intensive treatment. In the evaluation, he complained of a moderate pain at shoulder level, which was worst with extension movements and flexion of that articulation; difficulty in movements of the forearm and fingers; coldness on the left superior limb and the hypoesthesia predominantly at distal level. At physical examination it was found that tone and trophism were decreased, the muscular force too and it was also found that the affected side was colder than the healthy one. According to the bioenergetic diagnostic, it was considered as a syndrome of emptiness and stagnation caused by emptiness of qi and blood in the channels and collaterals of the affected side.

Treatment

The general strategy was to tonify qi and blood in channel and collaterals to promote free circulation of qi and xue. Acupuncture and Moxibustion were then applied in the Yangming channel at points such as LI-4, LI-10, LI-11, and LI-15 and to the points Baxie, GV14, TE-5, alternatively in the healthy and in the affected side. He was treated twice a week for 2 months.

Result

The same day of starting treatment the pain disappeared. 12 days later, an elevation of the temperature of superior limb was observed to be similar to that of right arm and also an elevation of muscular tone and amelioration in index and medial fingersís motility which followed improving after the treatment.

Comments

Pain-related improvement was expected, but due to the etiology and evolution of the lesion, it was interesting to observe the presence of thermical and motor improvements which could be related with neuroplastic changes inducted by Acupuncture and Moxibustion.