Erb's Palsy, also known as Erb-Duchenne Palsy or Brachial Plexus Paralysis, is an injury caused during the birthing process and affects the brachial plexus nerves, which are the primary nerves that supply any feeling or movement in the arm, and can result in weakness or even paralysis to the shoulder muscles. This group of nerves begins at the neck and continues down the spinal cord leading to the hands. Erb's Palsy can affect just one of the nerves or even all five and can also affect other arm nerves that may have been injured at the same time.A complication of delivery during childbirth is referred to as dystocia. Erb's Palsy is the result of a complication that involved the infant's head and neck being pulled in one direction while the shoulders and arms where passing through the birth canal causing the nerves to stretch along the neck, shoulders, and arms during the process. Another example that may result in Erb's Palsy would be when the infant's shoulders are excessively pulled during a vertex, or head first, delivery. Furthermore, during a breech delivery, or feet first, should an over amount of pressure be placed on the raised arms, this can lead to Erb's Palsy. Any of these complications can lead to nerve damage ultimately ending in Erb's Palsy.
There are four types of injuries to the nerves that generally cause Erb's Palsy. The avulsion is when there is complete separation of the nerves from the spine. When the nerve is torn throughout but not at the spine, this is referred to as rupture. The praxis, or stretching, of the nerve is the result of the nerve being damaged by not torn. Lastly, the neuroma injury occurs when pressure from scar tissue that has built up from the original injury is placed on the nerve preventing the nerve from being able to send messages to hands from the spine.
A diagnosis for Erb's Palsy may be done based on a physical examination and certain test being performed. These tests could consist of a nerve conduction study being done and EMG, or anatomic studies such as an MRI or CT myelogram. As Brachial Plexus injuries can cause suffering in approximately two out of every 1,000 people, only about ten percent of these will actually require treatment.
Once a diagnosis has been made, some babies will recover on their own while other babies will require specialist intervention. With the avulsion fracture repair, neonatal neurosurgery may need to be performed aiding in the lesions to heal over time resulting in nerve function to return. Often times, physiotherapeutic care may be necessary to regain muscle usage. Children under the age of one may regain full recovery in range of motion, whereas older individuals that have not healed may actually rarely ever gain the full functionality of the arm and may also end up developing arthritis as a result.
Treatment should be started within a few days of Erb's Palsy being diagnosed. Regardless of the method of treatment that may be necessary, recovery should be complete and take place within the first few months. Still, approximately two out of ten infants may actually maintain some paralysis because of Erb's Palsy.
Should a child suffer from Erb's Palsy, this could be the result of medical malpractice. Contact this office here to receive a consultation about possible legal options.
