What are the Causes and Symptoms of Erb's Palsy?

erb's palsy

It’s every parent’s worst nightmare.  Something is not quite right with your new-born child.

Unfortunately, there are a host of things that can go wrong during the delivery of a baby, none of them is your fault, and some of them can be avoided.

Medical records tell us that children have suffered from physical birth trauma since the 16th century. Even with today’s medical advances – it still happens.

In the case of Erb’s Palsy, these injuries can have serious long-term effects, such as partial paralysis.

Read on to find out what you can do if your child is diagnosed with this condition at birth.

What is wrong with your baby?

Usually, the nursing staff or doctors present at the birth of the child will detect any signs of Erb’s Palsy immediately and begin treatment.

They will also be able to advise you on a long-term plan with regard to your child’s treatment.

The signs are:

  • Inability to move an arm or shoulder at all – even the smallest infants do move their limbs about.
  • Unnatural arm position – the arm on the affected side is limp and may be held curved towards the body.
  • Impaired reflexes – the affected arm will not respond to stimuli normally.
  • Loss of Feeling – infants do not seem to notice when the affected arm is touched or tickled.
  • Pain – pain may occur in the neck, shoulder or arm on the afflicted side and the baby will scream when touched in these areas.
  • Decreased Grip – the natural reflexive grip of the infant may be absent or weak.
  • Waiter’s Tip Posture – if the bicep muscles are damaged, the child may appear to be tipped towards the affected side.

In many cases, Erb’s Palsy can be treated successfully over time, as long as it is diagnosed as quickly as possible.

What is Erb’s Palsy?

Erb’s Palsy is also known as Erb–Duchenne Palsy. It also is known as brachial plexus birth palsy.

It is a neurological condition which affects the brachial plexus nerve network. This grouping of nerves is responsible for feeding impulses from the spinal cord to the nerves in the arm.

Any damage to the brachial plexus results in total or partial paralysis of one of the child’s arms. The degree of damage will determine how severe and long-lasting this affliction is.

How did it happen?

Erb’s Palsy is caused by physical injury to the brachial plexus nerves in the shoulder of an infant during the birth process.

Some types of Erb’s Palsy are caused by an unnatural stretching of the child’s neck by forceps or vacuum extraction during birth.  More severe forms can occur when the infant’s one arm becomes lodged in the mother’s pelvic cavity after the baby’s head has emerged.

This is an extremely risky situation and all obstetric doctors are trained to deal with it swiftly.  There are several factors that indicate to medical staff that they should prepare for this emergency during labor:

  • Large infants with a high birth weight
  • A petite mother
  • Excessive weight gain during pregnancy
  • Second stage of labor lasting over an hour
  • Breech delivery

While the severity of brachial plexus birth palsy may vary from mild to serious, medical incompetence is almost always a contributing factor. Knowing about the condition means understanding your child may be the victim of malpractice.

Types of Erb’s Palsy

There are four different ways in which your child’s nerves may have been damaged during delivery.

  • Neurapraxia – This is the most common type of nerve injury which occurs when a nerve is stretched. Just like a muscle injury, this affliction usually heals by itself within about 3 months.
  • Neuroma – In this case, the nerve fibers are damaged.  As they start to heal, scar tissue is formed which applies pressure to the healthy parts of the nerve. A partial recovery is a good option in this scenario.
  • Rupture – When the nerve itself is torn, surgical intervention is required to graft a healthy nerve onto the damaged portion to assist with healing.
  • Avulsion – When the nerve has been torn totally away from the spinal cord, and it cannot be reattached. In some cases, nerve grafts have been successful in restoring some functionality to the afflicted arm.

It is impossible to tell which kind of nerve damage your infant may be suffering from without an in-depth examination. S-rays, EMGs, an MRI, or nerve conduction studies can all help to determine the severity of the harm done and should be carried out as soon as possible to give your baby the best chance of recovery.

What to expect

Depending on how serious the case is, your child may need surgery.

They will most certainly need ongoing physical and occupational therapy to help them function to the best of their ability.  This can amount to years of consultations, patience, and sacrifices on your part.

The good news is that 70 to 80% of Erb’s Palsy cases clear up within a year with consistent treatment.  In more severe cases it is often possible to re-establish an acceptable level of recovery.

Unfortunately, some children may suffer long-term effects such as permanent functional loss and abnormal contractions in the affected arm.

Psychological harm can also develop due to the child feeling abnormal.  If your child is one of these unfortunates, take the time to build up their self-esteem. Try to involve them in family activities, and introduce them to sports and hobbies that they can participate in.

A child psychologist can help tremendously with any emotional problems that your child is experiencing.  You will also benefit from counseling to deal with the trauma of this experience.

All this costs money, and you are entitled to compensation.

Get help

Nothing can make up for the anxiety and trauma caused to you if your child has Erb’s Palsy.

However, by means of respondeat superior, the hospital is responsible for the actions of its employees.

Get legal counsel, and pursue a birth injury lawsuit which will help to pay for the costs associated with trying to undo the damage and give your child the best chance that you can.

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