Erb’s Palsy – an Update

Defining Erb’s Palsy

Erb’s palsy refers to a brachial plexus injury and occurs at the time of birth.  Brachial plexus is the group of nerves providing movement and sensation to the fingers, arm and hand.  In simple words, this nerve plexus connects the brain to the hand and the arm.

Doctors classified or divide brachial nerve injuries according to their severity. The severity of the injury determines the form of prognosis and treatment for recovery. Following are the symptoms of brachial plexus injuries:

• Paralysis (no feeling) in the hand or arm
• Movement of hand without any use of elbow and shoulder
• Arm movement with no or little use of wrist and hand

One of the major characteristics of Erb’s palsy is no feeling of arm that is an infant’s arm lies straight down without any movement. In some cases, the wrist is bent, arm turned and the fingers straight. If a doctor observes droopy eyelid on the same side of the body, it indicates severe nerve damage.

Approximately, two out of every one thousand babies born by vaginal birth suffers from brachial plexus injury. Often, these injuries occur when the baby passes via the birth canal. If doctors exert pressure on the shoulder or neck of the baby during birth then it causes their neck to stretch resulting in the tear or stretch of brachial nerves. Brachial plexus injuries occur during difficult deliveries including prolonged labor, breech presentation or a large baby.  Larger than average babies are at an increased risk of developing this type of injury but babies of any size including premature babies may suffer from this injury. One of the leading causes of brachial plexus injury is Shoulder Dystocia.

Treatment

Surgery and Physical therapy are two treatments widely used for the treatment of Erb’s palsy. However, doctors usually suggest physical therapy first.

• Physical Therapy

Physical therapy exercises are important as they keep the baby’s muscles and joints fit. Involvement of a caregiver or parent is essential in the recovery of baby. It is important to do motion exercises daily and even three times a day. This treatment is highly effective when started at three weeks of age. In most of the cases, babies recover completely, but it may take up to three years with regular physical therapies. Parents should get their babies examined after every two or three months to assess the progress.

• Surgery

If babies fail to recover motor function after three or seven months then surgery is the another option. Nerve surgeries are beneficial for the babies less than a year old but they fail offer any help to the babies above one year old. When doctors surgically repair the neck, the rate or speed at which the nerve develops could take many months or years for the corrected nerves to reach the muscles. When the children gets older and continue to feel weakness in their hand, shoulder or arm then tendon transfer surgery proves to be helpful. Doctors perform tendon surgery only when children follow postoperative instructions easily. Physical therapy follows surgery for many months or even up to a period of a year.

Prevention

It is important for parents to increase their education and awareness about effective and safe protocols for managing shoulder dystocia, one of the main causes of brachial plexus injury.

If you believe that, your child suffers from Erb’s palsy due to the result of medical negligence or malpractice, then you should immediately contact an experienced birth injury attorney who will evaluate your claim. He will help you in filing a lawsuit so that you may receive monetary compensation for the damages.