Sir.—We enjoyed reading the recent paper by Charles and Jayam-Trouth regarding brachial plexus neuropathy (BPN) in childhood (Journal 134:299-300, 1980). We also have had experience with this disorder and agree that an infectious cause seems likely, particularly in patients with CSF pleocytosis.
However, we disagree with the authors' conclusions that childhood BPN has a uniformly excellent prognosis. We recently reported on two children with BPN and one of them, a girl with onset at age 1 year, has had no functional improvement over a two-year follow-up period.1 The child's left arm remains completely useless and extensive atrophy has occurred. We are also concerned about the authors' case 3, who has shown little improvement of limb weakness in the interim between the six-month and one-year examinations.
Childhood BPN seems to be an uncommon disorder, and despite occasional case reports in the literature the extent of our knowledge remains limited.