Decreased limb movements due to pain are referred to as pseudoparalysis. The neonate with pseudoparalysis cries and grimaces with even minimal attempts to move the affected extremity, but full motion can be elicited by primitive reflexes (Figure 194.1 A,B).
Figure 194.1.— Pseudoparalysis of the left arm [A and B]. Full range of arm movement produced by Moro reflex [B].
Neonates with pseudoparalysis have normal deep tendon reflexes. The painful limbs do not adopt the typical postures that characterize segmental brachial plexus palsy (Figure 194.2) or peripheral nerve lesions.
Figure 194.2.— Pseudoparalysis of the left arm. [A]: Left arm do not have the typical posture of Erb's palsy or Klumpke palsy. [B]. Clavicular fracture in the same patient.
Evidence of trauma or infection in the affected limb supports the diagnosis of pseudoparalysis. Pseudoparalysis occurs with bone fracture or with joint, soft tissue, or bone infections (Figure 194.3).
Figure 194.2.— Right leg drop in a patient with septic arthritis of the right hip [A and B].