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Erb's Palsy Often the Result of Birth Injury

Jun 12, 2014

Erb's Palsy, the weakness or paralysis of the arm, is usually the result of a birth injury to the brachial plexus, the network of nerves near the neck that sends signals to the shoulder, arm, and hand. 

Brachial plexus injuries can occur when the brachial plexus is stretched, compressed, or, in the worst cases, torn during birth. Erb’s Palsy occurs in one to two births in a thousand. The injury usually occurs when a baby's shoulder becomes stuck on the mother’s pelvic bone; this can happen with a large baby, a breech presentation, or a prolonged labor, the Mayo Clinic explains.

Brachial plexus injury may occur when someone exerts force to pull the baby from the birth canal. If the baby's neck is stretched severely, the nerves may also be stretched or torn, causing injury. The use of forceps, vacuum extraction, or other tools to guide the baby through the birth canal may also increase the risk of Erb's Palsy. Doctors may use different procedures to dislodge the baby's shoulder so that the baby can safely pass through the birth canal, and sometimes the injury is the result of the failure to use the proper procedure or to act quickly enough during a difficult delivery.

Minor brachial plexus injuries may get better on their own, but more serious injuries may require surgical repair.

Erb’s Palsy is typically discovered following birth. Symptoms include:

  • inability to move the arm or shoulder
  • arm bent inward, toward the body
  • weak or no reflexes in the arm
  • no feeling or sensation in the arm or hand
  • limp or paralyzed arm
  • lack of muscle control in the arm, hand, or wrist

Where the injury is less severe, the baby may recover without treatment, or with physical therapy. Where the nerves have been cut or torn, surgical repair may be necessary to reattach or replace nerves or damaged sections or to transfer muscles or tendons, according to the Mayo Clinic. Even with treatment, some children will have lifelong limitations in the affected hand or arm.

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