Brachial Plexus and Peripheral Nerve Disorders Program

The Brachial Plexus and Peripheral Nerve Disorders Program at Nicklaus Children’s provides comprehensive care for newborns, infants and children who have sustained an injury to the brachial plexus – a network of nerves emerging from the spinal cord at the base of the neck – resulting in weakness, numbness and/or discomfort. Injuries to the brachial plexus can occur during the birthing process or as a result of trauma, including falls, sports injuries and vehicle collisions. Thus, newborns and children of all ages can be affected.

In addition, the program focuses on children with injuries or diseases (including tumors) of the peripheral nerves.

Who is a Candidate for the Program?

  • Infants and newborns with limited or no movement of an arm, wrist or hand following birth.
  • Children or teens who have experienced trauma and have reduced sensation in the hand or arm, or inability to control movement in the arm, wrist or hand.
  • Children who may have unexplained masses associated with weakness, numbness, pain or discomfort in any of the limbs.

Treatments and Procedures

What Should I Expect?

At the initial visit, the child will be seen by the neurosurgeon and other team members and a medical history will be taken. Please bring all medical records and images of the associated injury. Some children may require one or more imaging studies to evaluate nerve and muscle function.

Imaging studies that may be prescribed include:

  • MRI scans
  • CT scans
  • Nerve function tests (including electromyogram and nerve condition studies)
  • X-rays

Approaches to Treatment

The severity of brachial plexus injuries varies widely. The majority of babies and children make a full recovery with physical therapy alone, while others may require extensive therapy and surgical intervention. Treatment includes, but is not limited to:

  • Physical and occupational therapy to restore motion and strength.
  • Specialized splints may be used to protect the injury from further harm.
  • Early surgical interventions, including surgical exploration, neurolysis to release the nerve from surrounding scar tissue, removal of damaged nerve tissue, and nerve transfers to stimulate nerves and muscles with the goal of enhancing function.

Additional procedures that may be recommended as children grow include tendon or muscle transfers, release of tight muscles or joints, joint fusions and botox injections.

A Multidisciplinary Approach

Pediatric patients with brachial plexus and peripheral nerve disorders benefit from a multidisciplinary approach that brings together an entire team of specialists to participate in the evaluation and care management.

The team at Nicklaus Children’s Brachial Plexus and Peripheral Nerve Disorders Program includes:

  • Pediatric neurosurgeons
  • Pediatric plastic hand surgeons
  • Pediatric orthopedic surgeons
  • Pediatric neurologists
  • Physical and occupational therapists specializing in managing pediatric patients

Dr. Aaron Berger is a pediatriac hand surgeon at Nicklaus Children's Hospital. For more information about the Brachial Plexus and Peripheral Nerve Disorders Program, please visit

Service Locations

Nicklaus Children's Hospital Main Campus
3100 SW 62nd Avenue
Miami, FL 33155