Erb's Palsy

Erb’s Palsy is a brachial plexus disorder. What does that mean? The brachial plexus is a cluster of nerves where the neck meets the shoulder, on each side. They travel from the spinal cord, between the vertebrae, through each armpit and down into each arm and provide almost the entire arm and hand with movement ability and skin sensation.

When a baby has Erb’s Palsy, the most frequent indication is lack of movement in one arm. The arm will be straight down at the baby’s side and sometimes it will be a little turned, with the wrist bent and the fingers straight. There may also be a droopy eyelid on the same side if the injury is more severe.

Birth injury

The brachial plexus is sometimes injured during a difficult birth, such as:

· When the baby is in a breech presentation
· When the baby is particularly large
· When labor goes on a long time
· When forceps must be used to help the baby emerge from the birth canal

The injuries are a stretching or tearing of the brachial plexus nerves. The resulting arm disability is usually on one side only, as the baby’s neck is stretched while one shoulder is caught against the mother’s pelvic bone, so only one brachial plexus is damaged rather than both.

Some birth injuries are avoidable with attentive and responsible medical care. If your baby has Erb’s Palsy, you might benefit from some legal assistance in discovering whether or not that injury could have been avoided. Were the forceps used too vigorously? Should a caesarian section have been performed? Could the labor have been shortened? Were attending medical personnel negligent in any way? Obtaining answers to this type of question can take some time, so don’t delay in contacting a personal injury attorney.

Two groups of nerves

The nerves that come together in the brachial plexus belong to two groups: those traveling to the arm, and those traveling to the hand and fingers. The nerves to the arm originate higher on the spinal cord, so they exit between vertebrae higher up, whereas the nerves to the hand and fingers originate slightly lower on the spinal cord and exit lower, just above the chest.

Because there are these two groups of nerves which are separate before they join in the brachial plexus, two types of damage can be sustained:

Erb’s Palsy – where the upper nerves are damaged, those traveling to the arm Global Palsy – where both groups of nerves are damaged; this is more severe

Types of injury

There are four types of nerve injury, with different resulting disabilities:

1. Stretching – The nerve is damaged but not torn, and this is the mildest scenario, usually healing up by itself within about three months
2. Avulsion – The nerve is torn from the spinal cord, and this is the most severe scenario, requiring treatment
3. Rupture – The nerve is torn, but not from the spinal cord
4. Neuroma – The nerve is injured by pressure from scar tissue which forms after the original injury

When a nerve is injured, regardless of how that happened, the result is numbness and loss of movement.

Treatment

Since stretching is the most common type of brachial nerve injury, and this heals by itself within a few months, no treatment is needed in most cases of Erb’s Palsy.

But if no improvement is evident after three months, surgery may be performed, and a splint worn afterwards for about three weeks. This will not immediately solve the problem, because growing at the approximate rate of an inch per month, it will be a while before nerves that are repaired at neck level reach the hand and lower arm muscles.

If the child is older and can follow instructions, a tendon transfer may be done, which moves the tendon attachment. Tendons are the connective tissue connecting muscles to bones. This can help the child with shoulder and wrist movements and hand grip. A cast will have to be worn for about six weeks, and at night, a splint will be worn for about six months. Physical therapy will also be part of this follow-up.

When your baby has been injured, it’s painful and baffling for the parents, and it can be hard to know where to turn for help. The thing you need for practical help and support is legal advice, legal representation, and all the paperwork done for you.

For more information on Erb’s Palsy and other birth injuries, click here to contact a personal injury attorney.

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