Understanding Erb’s Palsy
Also known as brachial plexus palsy, Erb’s palsy results from damage to the brachial plexus. The brachial plexus is the network of nerves that send signals from the spine to the shoulders, arms and hands. Symptoms of Erb’s palsy are no feeling or weakness in the arm or shoulder.
When an infant’s shoulder is caught behind the mother’s pubic bone during childbirth—a circumstance known as shoulder dystocia—a brachial plexus injury may result as those nerves get stretched or torn.
When the upper nerves are damaged, the injury can lead to Erb’s palsy. When the lower nerves are damaged, the injury leads to a condition known as Klumpke’s palsy.
When both the lower and upper nerves of the brachial plexus are injured, total brachial plexus palsy results.
Sadly, Erb’s palsy is often preventable with proper medical care during birth. Fortunately, in many cases, children can recover from the damage and regain feeling in their arms.
Causes of Erb’s Palsy
Physically pulling on a baby during delivery can cause damage to the brachial plexus. This nerve damage can lead to Erb’s palsy.
- The baby’s head and neck pulling toward the side as the shoulders pass through the birth canal
- Pulling the baby’s shoulders during a head-first delivery
- Pulling on the baby’s feet during a feet-first (breech) delivery, which puts too much pressure on the infant’s arms
- Shoulder of infant catches on pubic bone during delivery (shoulder dystocia)
Many of these causes can stem from medical negligence, such as the doctor using excessive force when delivering the baby.
Types of Erb’s Palsy
Erb’s palsy is classified by the extent of the nerve damage and where the damage occurs.
The four types of Erb’s palsy are:
- Neurapraxia: stretching of the nerve without tearing
- Rupture: tearing of the nerve without separation from the spinal cord
- Avulsion: the nerve tears away from the spine and will not heal on its own
- Neuroma: growth of scar tissue around the injury that places pressure on healthy, uninjured nerves, preventing these nerves from sending signals to the muscles
Treating Erb’s Palsy
Most babies with Erb’s palsy have a mild injury which should heal on its own. However, there are many cases where Erb’s palsy will not heal by itself. These cases might need treatment such as therapy or even surgery.
Because a child with Erb’s palsy typically cannot move the affected limb independently, daily physical therapy is encouraged for proper Erb’s palsy treatment. Occupational therapy and hydrotherapy might also be part of a treatment regimen.
In some cases, a doctor might recommend surgery for Erb’s palsy to repair the damaged nerves.
Erb’s Palsy in Newborn Babies
According to the American Academy of Orthopedic Surgeons (AAOS), Erb’s palsy affects about one out of 1,000 newborns. One symptom of Erb’s palsy in newborn babies is a limp or unresponsive arm or hand.
The good news is that Erb’s palsy in newborns is often mild and will heal on its own. If the nerves are simply stretched, movement and feeling can eventually return to their affected arm.
However, Erb’s palsy in newborn babies is more serious in some cases. More severe cases of Erb’s palsy, such as a brachial plexus avulsion, will require therapy or surgery to help manage the condition.