Erb’s Palsy

Erb’s PalsyBirth is never an easy process for the mother or the baby. Childbirth is a stressful process in which both are also at risk of injury. There is a long list of possible injuries an infant may suffer from just before, during, and right after birth. Some injuries may cause a lifelong problem like attention deficit hyperactivity disorder (ADHD). Others can do far worse, resulting in cerebral palsy. One condition that can affect a newborn for life, Erb’s Palsy, has a number of symptoms that range from the very mild to the severe.

What Is Erb’s Palsy?

Erb’s palsy is an adverse form of obstetric brachial plexus disorder and is usually triggered by an injury that takes place during the birthing process. For whatever reason, nerves in the baby’s upper arm become damaged resulting in a lifelong condition. Usually, one to two babies out of every 1,000 will be affected by Erb’s palsy. It gets its name from Erb’s point, an area on the baby’s anatomy located near the neck where the injury occurs. This point is where the brachial plexus forms by the connection of the fifth and sixth cranial nerves.

The brachial plexus is central in the operation of a person’s arms, hands and fingers. This system of nerves makes movement and feeling possible. During a difficult birth, shoulder dystocia usually causes Erb’s palsy. While the infant may still be able to wiggle their fingers, the condition prohibits their ability to move their shoulder or upper arm.

In some cases, Erb’s palsy affects the entire trunk. Unfortunately, this means it also impacts the spinal cord, impeding its ability to send messages to the arm, hand, wrist and fingers through the typical system of nerve impulses. This is why babies with Erb’s palsy sometimes appear as though their affected arm is paralyzed.

Note that Erb’s palsy only refers to damage done to the brachial plexus’ upper nerves. Sometimes, damage can occur on both ends of this nerve pattern, which can result in a much more severe disorder known as global or total brachial plexus palsy.

Risk Factors Involved with Erb’s Palsy

As we mentioned at the beginning, Erb’s Palsy usually occurs during a difficult birth.

Risks include:

  • Small maternal size
  • Large infant size
  • Excessive weight gain by the mother
  • Improper use of birthing tools
  • The second stage of labor going on for more than an hour
  • Infants coming out in the breech position

Types of Nerve Injuries

There are four kinds of nerve injuries. They can all happen at the same time and each will result in a loss of tactile functions and paralysis. Treatment of these injuries will depend on the severity of them. This is also the biggest factor affecting a child’s prognosis.

Neuropraxia is the most common kind and usually feels like a burning sensation or a shock runs up and down the injured nerve. Fortunately, it usually heals itself within three months.

A more serious injury would be neuroma. This is when nerve fibers become damaged and the resulting scar tissue that forms puts too much weight on the healthy nerve remaining. The pressure keeps the injury from completely healing.

Ruptures are when the nerve is actually torn. Something this severe always demands medical intervention and will never heal on its own. Nerve grafts are usually necessary.

The most severe type of nerve injury is an avulsion. That is what happens when the nerve is completely torn off the spinal cord. They also do not heal on their own. In fact, the nerve cannot even be reattached. However, a nerve graft may work to restore some functions.

The best thing you can do is detect the problems associated with Erb’s palsy early and then seek treatment at a hospital that features multidisciplinary specialties. Depending on the severity of the injury, children with Erb’s palsy can make a full recovery.