Newborn With Bilateral Wrist Drop: A Rare Presentation of Isolated Radial Nerve Palsy

Isolated radial nerve palsy in newborns is rare, marked by impaired wrist and finger extension with preserved shoulder and elbow function. Differential diagnosis includes brachial plexus injuries and rare tumors. We present a case of a preterm infant, delivered by cesarean section after 35 weeks+5 days of uneventful pregnancy, who presented with bilateral wrist drop and asymmetrical skin lesions. Ultrasound revealed subcutaneous adipose necrosis in the left arm, suggesting radial nerve compression. Conservative management was initiated, focusing on passive mobilization and neurosensory stimulation. Over time, we observed a gradual recovery of wrist and finger extension bilaterally. Isolated radial nerve palsy in newborns usually presents a favorable prognosis, with spontaneous recovery typically occurring within six months. The early identification and differentiation of less serious conditions from more severe ones are crucial for effective management and for reassuring parents. Implementing early rehabilitation interventions, as demonstrated in the present case, can enhance recovery outcomes and mitigate the risk of musculoskeletal complications.

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Journal
Cureus
Published
2025-06-27
DOI
https://doi.org/10.7759/cureus.86879
Primary Topic
Nerve Injury and Rehabilitation
Type
article
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article

Newborn With Bilateral Wrist Drop: A Rare Presentation of Isolated Radial Nerve Palsy

Ana Gomes, Ida M Frazoa, Bruno Paiva, Dieni Da Silveira Teixeira et al.
Cureus
Nerve Injury and Rehabilitation
article

Newborn With Bilateral Wrist Drop: A Rare Presentation of Isolated Radial Nerve Palsy

Ana Gomes, Ida M Frazoa, Bruno Paiva, Dieni Da Silveira Teixeira, Ítalo Souza Rodrigues
article en

Abstract

Isolated radial nerve palsy in newborns is rare, marked by impaired wrist and finger extension with preserved shoulder and elbow function. Differential diagnosis includes brachial plexus injuries and rare tumors. We present a case of a preterm infant, delivered by cesarean section after 35 weeks+5 days of uneventful pregnancy, who presented with bilateral wrist drop and asymmetrical skin lesions. Ultrasound revealed subcutaneous adipose necrosis in the left arm, suggesting radial nerve compression. Conservative management was initiated, focusing on passive mobilization and neurosensory stimulation. Over time, we observed a gradual recovery of wrist and finger extension bilaterally. Isolated radial nerve palsy in newborns usually presents a favorable prognosis, with spontaneous recovery typically occurring within six months. The early identification and differentiation of less serious conditions from more severe ones are crucial for effective management and for reassuring parents. Implementing early rehabilitation interventions, as demonstrated in the present case, can enhance recovery outcomes and mitigate the risk of musculoskeletal complications.

CureusVol. 17(6)
Algarve Biomedical Center (PT)
Zero hunger
Openalex Percentile: Top 74%
Nerve Injury and Rehabilitation
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