Erb’s Palsy - Causes, Symptoms, Treatment, and Prognosis

Top 4 topics on this page:

What Is Erb's Palsy?
Causes of Erb's Palsy
Symptoms of Erb's Palsy
Erb's Palsy Treatment

What Is Erb’s Palsy?

1 out of 1000 babies are born with Erb's Palsy

According to the American Academy of Orthopedic Surgeons (AAOS)

Erb’s palsy, also called brachial plexus birth palsy or Erb-Duchenne palsy, is a condition caused by nerve damage during the birthing process.

The brachial plexus is a network of nerves that send signals from the spine to the shoulders, arms, and hands. Erb’s palsy can develop if these nerves are pulled or stretched too hard.

Types of Erb’s Palsy Injuries

There are several types of Erb’s palsy injuries. The type of brachial plexus injury a child develops can depend on the severity of damage to the nerve network.

The four types of nerve injuries are:

Neuropraxia

This is the most common type of Erb’s palsy. In this type, the nerves are stretched but not torn, causing a stinging or burning sensation. Neuropraxias generally heal on their own in three months or less.

Neuroma

More severe than neuropraxias, neuromas occur when scar tissue develops as nerves heal from an initial tear. This places pressure on healthy nerves. Most children with neuromas will only partially recover.

Rupture

This injury occurs when the nerve is torn. This type of injury does not heal on its own and generally requires nerve graft surgery to put damaged nerves back together.

Avulsion

This is the most severe brachial plexus injury and occurs when the nerve roots are completely torn from the spinal cord, resulting in permanent muscle weakness/paralysis. Surgery can help repair torn nerves, but cannot reattach them to the spinal cord.

Causes of Erb’s Palsy

One of the most common causes of Erb’s palsy is a condition called shoulder dystocia, which occurs when an infant’s shoulder is caught behind the mother’s pubic bone during childbirth.

When a medical professional pulls on the baby to release their shoulder, it can stretch or tear the healthy nerves of the brachial plexus.

Other situations that may cause Erb’s palsy include:

Pulling the baby’s head or neck sideways as they pass through the birth canal during a difficult delivery
Pulling the baby’s shoulders during a head-first delivery
Pulling on the baby’s feet during a feet-first (breech) delivery, putting too much pressure on the infant’s arms
Shoulder dislocation or fractures in the collarbone (clavicle)

All of the actions listed above may be considered medical negligence. Doctors, nurses, and other medical professionals who use too much force during delivery can cause preventable cases of Erb’s palsy.

There are also a few risk factors that may increase the odds of a child developing a brachial plexus nerve injury during delivery.

Risk factors leading to Erb’s palsy include:

Abnormal maternal pelvis shape
Birth weight over 8 pounds, 13 ounces (macrosomia)
C-section (cesarean section)
Maternal diabetes
Maternal obesity
Second stage of labor lasting longer than one hour
Use of forceps or vacuum delivery

Talk to one of our caring registered nurses today to learn if your child’s injury was caused by medical negligence.

Other Types of Brachial Plexus Injuries

There are other types of brachial plexus injuries besides Erb’s palsy. These injuries are much rarer than Erb’s palsy, but present similar symptoms and respond to the same treatments.
Other types of brachial plexus injuries include:

Klumpke’s Palsy: This type of injury involves nerve damage in the lower arm and affects mobility in the hand and wrist.
Total Brachial Plexus Palsy: This condition involves nerve damage in both the lower and upper arm and causes complete paralysis in the affected limb.

Since these conditions have similar signs as Erb’s palsy, it is important to get a proper diagnosis from a doctor in order to get the best treatment.

Erb’s Palsy Symptoms

There are several common symptoms that may mean a child has developed Erb’s palsy. These Erb’s palsy symptoms can vary depending on how damaged the brachial plexus nerves are.

Notable signs of Erb’s palsy include:

Limited ability to grasp objects or only using one hand to grasp
Limited muscular or nerve development in the arm or hand
Limp arm, wrist, or hand
Muscle weakness in one arm
Numbness or tingling in shoulder, arm, or hand
Partial or complete paralysis of the arm

If you had a difficult childbirth and your baby is experiencing any of the symptoms listed above, they may have developed preventable Erb’s palsy.

Diagnosis of Erb’s Palsy

If you suspect your child has Erb’s palsy, you should consult your doctor or pediatrician. Only a medical expert can accurately make an Erb’s palsy diagnosis.

A doctor will conduct several examinations and imaging tests to diagnose brachial plexus palsy.

Common Erb’s palsy assessment tests include:

CT (computed tomography) scan: This scan takes images from several angles of the body to search for damage to soft tissues such as the brachial plexus.
MRI (magnetic resonance imaging) scan: This scan takes images of the internal tissues in the body to look for brachial plexus nerve damage.
Nerve conduction study: This physical test finds how quickly the electrical impulses from electrodes travel through the brachial plexus nerves.
Physical examination: Doctors will look for any physical signs of nerve damage such as muscle weakness and limited mobility of the arm, shoulder, wrist, or hand.

Your child’s doctor may use a combination of these diagnostic tests to determine an accurate diagnosis.

Preparing for the Doctor’s Appointment

When prepping for your child’s doctor’s appointment, it’s important to note their symptoms and how long they have been going on for. Early detection and treatment are the keys to fully recovering from Erb’s palsy.

Erb’s Palsy Prognosis

Once your child has been diagnosed, your doctor will give you a prognosis. An Erb’s palsy prognosis is the expected outlook of the condition. Thankfully, the overall outlook for brachial plexus palsy is generally very good.

Erb’s Palsy Recovery Outlook

According to a study conducted by Dalhousie University and the IWK Health Centre in Nova Scotia, 80% to 96% of newborns will completely recover from Erb’s palsy.

With prompt and proper therapy, mild cases of Erb’s palsy heal within a few months. However, severe cases may never fully heal, even with treatments like therapy and surgery.

Catching Erb’s palsy as early as possible is the best way to ensure your child can get effective treatment.

Erb’s Palsy Treatment

Doctors will use your child’s diagnosis and prognosis to determine the best treatment plan for their condition.

Mild cases of stretched nerves may only require physical therapy. More severe cases of torn nerves may require intensive treatment and surgery to help the child regain mobility of their arm, hand, or shoulder.

The key to recovering fully from Erb’s palsy is to start treatment early. Erb’s palsy treatment is most effective when it begins within the first four weeks after the child’s birth. Most babies with Erb’s palsy will recover completely within 12 months of age with proper treatment.

Most babies with Erb’s palsy will recover completely within 12 months of age with proper treatment.

Learn more about treatment options for Erb’s palsy below.

Physical Therapy

Most cases of Erb’s palsy are mild and can heal with physical therapy.

Physical therapy activities for Erb’s palsy include:

Range-of-motion exercises
Sensory activities
Strength training
Stretching

The best type of physical therapy for your child depends on the issues they face. Stretches and range-of-motion exercises can improve a child’s control over their arm, while sensory activities can help to restore any lost feeling.

Doctors may also incorporate water therapy into an Erb’s palsy physical therapy plan to reduce stress on the child’s body and to help them move freely.

Occupational Therapy

Occupational therapy may be used to help children improve the use of their hands and fingers. This type of therapy focuses on these exercises to improve independence and ability to complete daily tasks.

Occupational therapy can help children refine their skills while:

Bathing
Brushing their teeth and hair
Drawing
Dressing
Eating and drinking
Writing

Surgery

Surgery for Erb’s palsy can repair damage to brachial plexus nerves that will not heal on their own, such as avulsions. It is typically used only if your child does not show improvement despite other treatment options.

Nerve or tendon transfers remove healthy nerves from another part of the body to repair damaged brachial plexus nerves. Doctors may even decide to completely remove severely damaged nerve fibers that cannot be repaired.

While a more drastic measure than regular therapy, surgery is often successful. Researchers in
Nova Scotia reported that surgery improved the symptoms of Erb’s palsy in roughly two-thirds of patients.

Legal Help for Erb’s Palsy

Many cases of Erb’s palsy are caused by medical mistakes during delivery. Doctors, nurses, and other health care providers who commit acts of medical negligence during the birthing process can cause significant damage to the brachial plexus.

Medical professionals who cause preventable birth injuries should be held accountable for their actions. Your family should not be responsible for paying for your child’s Erb’s palsy treatment if it was preventable.

Thankfully, you may qualify for financial assistance through a medical malpractice claim. Compensation from a legal settlement can help you pay for your child’s Erb’s palsy treatment in hopes that they’ll fully recover.

If you believe your child’s Erb’s palsy stems from medical negligence during birth, get a free case review now to learn more about getting compensation.

Erb’s Palsy FAQs

What causes Erb’s palsy?

Excessively pulling, stretching, or twisting the brachial plexus nerve network can cause a child to develop Erb’s palsy during the birthing process.

Can Erb’s Palsy be fixed?

Yes. Although every case is different, most cases of Erb’s palsy can be completely or partially fixed.

How can I give my child the best chance of a full recovery from Erb’s palsy?

The best way to help your child fully recover from Erb’s palsy is to get a prompt diagnosis and proper treatment.

The sooner your child is accurately diagnosed with Erb’s palsy, the sooner they are able to get treatment to manage their condition. Treatment focuses on helping the child regain strength and mobility in the affected arm in an effort to make a full recovery.

Is Erb’s palsy preventable?

It depends. Some cases of Erb’s palsy are caused by risk factors that may not be preventable. However, many cases are caused by lack of care during delivery.

Some medical professionals may use excess force during delivery, causing brachial plexus damage. In these situations, medical negligence may be to blame.

To find out if your child’s brachial plexus palsy may have been preventable, contact us today.