Diagnosing Erb’s Palsy

Quick Answer

Erb’s palsy is a nerve and muscular condition often caused by injury to the brachial plexus during birth. Children born with Erb’s palsy have muscle weakness or partial paralysis in the arm, shoulder, hand, wrist, and fingers. Children who are diagnosed and begin treatment quickly have the best odds at making a full recovery and regaining use of the affected limb. If you believe your child has Erb’s palsy, seek a diagnosis from your medical provider as soon as possible.

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How Doctors Diagnose Erb’s Palsy

When diagnosing Erb’s palsy, doctors evaluate your child’s symptoms and determine if more tests are necessary.

Symptoms that doctors look for include:

  • Muscle weakness in one arm
  • Limp arm
  • Reduced or limited ability to grip items
  • Lack of feeling or sensation in the shoulder, arm, wrist, hand or fingers
  • Partial or complete paralysis of the arm

If your child displays any of these symptoms, they should see a medical professional immediately for a professional evaluation. The quicker a diagnosis is received, the faster treatment can begin. This increases the odds of a complete recovery.

If a doctor suspects that your child has Erb’s palsy, the next step may be running diagnostic tests such as MRI or CT scans.

Testing for Erb’s Palsy

Doctors will run imaging tests in order to determine whether your child has Erb’s palsy. These tests generally involve an MRI scan or a CT scan.

Most MRIs and CT scans take a few hours to complete and often provide doctors with enough information to make a diagnosis. However, some doctors may order other tests, such as an X-ray, electromyography or a nerve conduction study.

Doctors are looking for the following conditions:

  • Ruptures in the nerve, which is a tear from excessive stretching
  • Scar tissue on the nerve, a condition called neuroma
  • Simple stretching of the nerve, also called neurapraxia
  • Complete sever of the nerve from the spinal cord

MRI Testing

MRI (Magnetic resonance imaging) scans are conducted with radio waves and magnetic fields. The images produced by MRIs give doctors a detailed look at the interior of a patient’s body. This allows them to detect brachial plexus injuries. MRIs can be used to determine the extent of the nerve damage and the right course of treatment to correct the injury.

CT Scans

CT (Computerized tomography) scans are computerized X-rays that give doctors more detailed images of muscles, nerves, bones and other interior structures. CT scans differ from MRIs in that CTs require the injection of a contrasting material to highlight the nerves in the body that are being examined. CT scans are usually only ordered if an MRI is inconclusive or doesn’t provide enough information.

Erb’s Palsy Prognosis

It is critical to understand the difference between a prognosis and a diagnosis. A diagnosis is the identification of a particular condition or illness conducted by examining particular symptoms. A prognosis is the likely outcome of medical treatment and a forecast of how the case can or will resolve.

Children who are diagnosed with Erb’s palsy may share the same condition but have a different prognosis. That is because the severity of Erb’s palsy can vary greatly between cases. One child may have a mild case of Erb’s palsy that resolves in a few months after physical therapy. Another child may require surgery in order to address a more severe case of Erb’s palsy.

Because over 80% of Erb’s palsy cases are successfully treated through physical therapy, the prognosis for most children with the condition is good.

Steps to Take After a Diagnosis

After your child has been diagnosed with Erb’s palsy, the typical next step is to begin physical therapy. Generally, this involves a weekly or biweekly session with a licensed physical therapist who will help your child exercise their affected arm. These exercises may be as simple as gentle massages or they may involve light weights.

The type of therapy depends on the severity of your child’s condition and what your medical provider thinks will be best to restore feeling and movement to your child’s arm and shoulder.

If you are interested in scheduling physical therapy, talk to your doctor or your health insurer. They will connect you with local physical therapists who may have experience with cases of Erb’s palsy.

Erb’s Palsy Misdiagnosis

In some cases, Erb’s palsy may be misdiagnosed. This is serious, because the longer it takes for your child to get treatment for Erb’s palsy, the lower their odds of making a full recovery.

If you believe that your child has been misdiagnosed and actually has Erb’s palsy, you should take your child to receive a second opinion immediately. On the other hand, if you believe your child does not have Erb’s palsy despite a diagnosis, a second opinion may find they have another condition.

Diagnosing Erb’s Palsy and Beyond

It is important to look out for the symptoms of Erb’s palsy directly after birth. If your child has muscle weakness in his or her arm, shoulder, wrist, hand or fingers, then you should immediately visit a medical provider to get  a diagnosis. Your doctor can conduct a series of tests, such as MRI and CT scans, in order to determine if your child has Erb’s palsy.

If your child does have Erb’s palsy, then the next step is usually physical therapy. The overwhelming majority of children diagnosed with Erb’s palsy will make a full recovery. However, a small percentage of children with the condition will have symptoms for life.

If your child has been diagnosed with Erb’s palsy due to medical malpractice, then you may be eligible for a financial settlement that can pay for some or all of their medical care.

Birth Injury Support Team

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
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  2. Erb's Palsy. (n.d.). Retrieved from https://www.aanem.org/Patients/Muscle-and-Nerve-Disorders/Erb-s-Palsy
  3. Partridge, C., & Edwards, S. (2004). Obstetric brachial plexus palsy: increasing disability and exacerbation of symptoms with age. Physiotherapy Research International, 9(4), 157–163. doi: 10.1002/pri.319