What Causes Erb’s Palsy?
Erb’s palsy, also known as brachial plexus palsy, is a birth injury characterized by loss of movement or weakness in the arm or shoulder. It develops when the collection of nerves around an infant’s shoulder are damaged during a difficult delivery.
Birth injuries to the upper part of the brachial plexus result in Erb’s palsy. Injury to the lower part of the nerves can cause Klumpke’s palsy. Injury to both the upper and the lower nerves of the plexus is called total brachial plexus palsy. All can cause significant, lifelong disability.
Erb’s palsy causes include:
- Pulling on the infant’s head and neck as the shoulders pass through the birth canal
- Pulling the infant’s shoulders during a head-first delivery
- Pulling on the infant’s feet during a feet-first (breech) delivery, which puts too much pressure on the infant’s raised arms
All of these Erb’s palsy causes in infants can be the result of medical negligence or improper medical care, such as the doctor using excessive force when delivering the baby.
However, there are some rare Erb’s palsy causes that are not due to birth injury. Traumatic injuries from contact sports and car accidents can also cause Erb’s palsy.
Erb’s palsy causes should be examined carefully to determine if medical negligence has occurred. Although some cases of Erb’s palsy are mild and can heal on their own, there are more severe cases that will require surgery or a lifetime of treatment.
For example, brachial plexus avulsion occurs when the nerve root is severed from the spinal cord. While infants may eventually recover from a more mild injury, a brachial plexus avulsion cannot heal on its own.
In some cases, the torn nerve can be helped by surgery.
In the delivery room, shoulder dystocia can be a terrifying emergency. Shoulder dystocia happens when the baby’s shoulder gets stuck behind the mother’s pelvic bone during delivery. If the medical team responds improperly to this emergency situation, a brachial plexus injury can occur.
Shoulder Dystocia Symptoms
Long term effects of a birth injury resulting from shoulder dystocia include:
- The inability to turn the head
- The arm cannot hug or reach out
- The inability to write or pick things up
The amount of paralysis depends on which nerves in the plexus are injured.
The most tragic cases of shoulder dystocia are the ones that could have been prevented.
While they may have the best of intentions, a member of the hospital staff may turn the infant’s head too hard or too far, or grab the shoulder. This pressure and strain can damage delicate nerves of the newborn’s brachial plexus.
Treatment Options After Shoulder Dystocia
The Mayo Clinic states that in most babies with Erb’s palsy, the injury heals without treatment. However, about 10 percent of children eventually need surgery. If the injury does not heal on its own in the first month, the baby should see a specialist.
Clinical specialists have found best results from performing surgery four to six months after birth before the nerve damage becomes permanent.