What is Erb’s Palsy?

Nearly four million babies are born each year in the United States. About 1,000 of them suffer a birth injury known as Erb's palsy, named for Dr. Wilhelm Erb, a German doctor who first described it. The word palsy means weakness, which is what this condition causes, along with loss of motion to the network of nerves near the neck known as the brachial plexus. All these nerves in the brachial plexus give both feeling and movement to the arm, hand, and fingers. Although this condition is generally considered to be a birth injury, it can occur from other causes such as trauma from a car crash.

There are four kinds of brachial plexus injury, and a newborn can suffer from them all at the same time. Neurapraxis is the most common. It is a shock to the nerve, but doesn't tear it and usually heals within three months. Neuroma may stretch the nerve and leave scar tissue, which puts pressure on healthy nerves and leaves some permanent damage. Rupture tears the nerve apart. Avulsion, the most serious type, tears the nerve away from the spinal cord.

Erb's palsy affects the upper and lower arm. These injuries more commonly occur with a breech delivery, meaning the infant's feet, rather than the head, appear first; or when the head has appeared but there is difficulty in moving the shoulder; or when the newborn is larger than average. Modern delivery techniques and the use of cesarean delivery have reduced injuries to the brachial plexus, but they still occur.

The symptoms of a newborn with Erb's palsy are generally immediately recognizable. There is no movement in the infant's upper or lower arm, or the arm is held against the body and bent at the elbow. The arm that is affected will usually flop about if the infant is moved from side to side. As soon as the diagnosis is made, x-rays and tests of nerves in the upper arm may be ordered. When the child is about three weeks old, a routine of physical therapy and motion exercises may begin daily. The object is to prevent the area from becoming permanently stiff.

After three to six months of no significant change in muscle strength, exploratory nerve surgery may help to improve function. Most children born with this injury can recover feeling and movement in the affected area. However, the longer the time without improvement, the less likely that normal or near normal function will take place. By that time and in those cases, avulsion may have occurred. The permanent result may be muscle tightening or abnormal muscle contractions or loss of some nerve function, which may result in paralysis of or weakness in the arm.

Because victims of Erb's palsy are usually so young, parents play a highly important role in the necessary physical therapy treatment. Daily exercises are highly important, as are a doctor's frequent examinations to test if nerves are recovering. A complete recovery, or to the full extent of recovery, may take up to two years.

If you had a child born with Erb’s palsy due to an automobile accident, contact www.DanknerMilstein.com today.

Disclaimer
The information in the above article is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact Danker, Milstein & Ruffo, P.C., and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.