Pediatric Peripheral Nerve Program
The Pediatric Peripheral Nerve Program offers multidisciplinary subspecialty care for patients with injury or conditions affecting the nerves of the body outside of the brain and spinal cord.
Treatment for Brachial Plexus Injury
One area of focus is restoring arm movement after birth related injuries, such as Erb’s palsy. At birth, the network of nerves that serve the arms (called the brachial plexus) can be injured such that the infant has weakness or inability to move the upper extremity. If strength does not recover by three to six months of age, surgery can be offered to free up scar tissue around the injured nerves to encourage nerve recovery. In other cases, an injured part of the nerve may be removed and replaced with a healthy nerve from elsewhere in the body (a nerve graft). Finally, a third option is to take a part of a working nerve and hook it directly into a non-working nerve to restore function (a nerve transfer).
Arm/Hand Weakness after Spinal Cord Injury
Although surgeons are not yet able to directly repair certain injuries to the spine itself, there are surgical techniques called nerve transfers that can be used to help restore certain functions in select cases of spinal cord injury following trauma, acute disseminated encephalomyelitis, or other demyelinating disorders. In these procedures, working nerves above the level of spinal cord injury can be rewired to serve muscles that are otherwise served by non-working nerves. Depending on the specific pattern of injury, goals of surgery include restoring elbow movement and the ability to pinch, grasp, and open fingers of the hand, which can result in significant improvements in quality of life.
Peripheral Nerve Tumors
In addition to treatment of traumatic injuries, we provide comprehensive care to patients with peripheral nerve tumors. If you think of a nerve as an electric wire, the insulation around the wire can sometimes give rise to a growth called a nerve sheath tumor. Other times, a growth may arise from the nerve itself. We treat all tumor types located in or along peripheral nerves, such as schwannomas, neurofibromas, malignant peripheral nerve sheath tumors, and perineuriomas, or in the networks of nerves serving the arms and legs called the brachial plexus and lumbar plexus. We have a strong relationship with Neuro-Oncology with specific expertise in patients with Neurofibromatosis types 1 and 2.
Before surgery, neuroradiologists offer advanced MRI of nerves, including the brachial plexus, which can help to guide interventions for a specific patient. After surgery, there is a strong reliance on physical and occupational therapy. In addition, colleagues in plastic surgery offer expertise in hand surgery (Logan Carr, MD) and facial nerve reanimation (Elizabeth Zellner, MD). The anesthesia and pain management service provides diagnostic and therapeutic interventions such as peripheral nerve blockage and peripheral nerve stimulation.
Conditions We Treat
- Brachial plexus injury
- Birth-related (obstetric) brachial plexus injury
- Erb’s palsy
- Klumpke palsy
- Thoracic outlet syndrome
- Carpal tunnel syndrome
- Cubital tunnel syndrome
- Complex regional pain syndrome
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(Morton) Neuroma
- Meralgia Paresthetica
- Sciatic nerve injury
- Peroneal nerve entrapment
- Laceration or blunt nerve injury
- Schwannoma
- Neurofibroma
- Perineurioma
- Malignant peripheral nerve sheath tumor (MPNST)
- Neurofibromatosis type 1
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Neurofibromatosis type 2
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Facial nerve palsy
- Brachial plexus tumor
- Upper extremity weakness after spinal cord injury
Contact Us
Phone: 914.775.5437
Fax: 914.650.5437
19 Bradhurst Avenue
Suite 3050 N
Hawthorne, NY 10532
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19 Baker Avenue
Medical Arts Pavilion
Suite 301
Poughkeepsie, NY 12601
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