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Intrauterine onset of a mononeuropathy: Peroneal neuropathy in a newborn with electromyographic findings at age one day compatible with prenatal onset
Author(s) -
Jones H. Royden,
Herbison Gerald J.,
Jacobs Stanley R.,
Kollros Peter R.,
Macones George A.
Publication year - 1996
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199601)19:1<88::aid-mus12>3.0.co;2-#
Subject(s) - mononeuropathy , medicine , electromyography , electrodiagnosis , age of onset , pediatrics , peripheral neuropathy , physical medicine and rehabilitation , endocrinology , diabetes mellitus , disease
Mononeuropathies are unusual at birth, and electromyographic (EMG) definition the first day of life has not been reported previously. Although neonatal mononeuropathies may be related to obstetric complications, prenatal mechanisms also merit consideration. We report an infant, born with a peroneal neuropathy, whose EMG was performed 18 h after birth. An isolated peroneal nerve lesion with lack of compound muscle action potential and the presence of fibrillation potentials, confined to the tibialis anterior muscle, suggested a primary intrauterine mechanism for this mononeuropathy. Because of an infant's small size, the temporal profile used in adults for appearance of EMG signs of wallerian degeneration may not apply. Inaccurate conclusions may result if the EMG standards for timing adult nerve injury are applied to newborns. To our knowledge, previously published cases of neonatal mononeuropathies have not included babies whose first EMG was performed before age 4 days. Therefore, an EMG study shortly after birth needed to be accomplished if strong support for the hypothesis of a prenatal onset were to be generated. Our findings are compatible with an intrauterine onset of this baby's peroneal neuropathy. © 1996 John Wiley & Sons, Inc.