(Erb-Duchenne Paralysis; Brachial Plexus Palsy)
Erb’s palsy happens when the baby’s neck is stretched during delivery. This can cause damage to the upper nerves of the neck and shoulder. The nerve damage can then cause certain muscles in the baby’s arm to be weak. Over time, the baby can recover movement. He can also recover feeling in the arm. In some cases, long-lasting damage can occur.
Erb’s palsy is usually caused by:
- Long, difficult delivery
- Delivery of a large baby
- Shoulder dystocia]]>
- Breech delivery
These factors increase your chance of delivering a baby with Erb’s palsy:
- History of delivering larger babies
- History of prolonged labor
- Gestational diabetes]]>
Tell your doctor if you have any of these risk factors.
Often, Erb’s palsy is discovered after birth due to the typical signs and symptoms, such as:
- Inability of your baby to move their arm or shoulder
- Arm is bent inward toward the body
- Weak or absent reflexes in the arm
- Loss of feeling in the arm
The doctor may:
- Ask about your baby’s symptoms and medical history.
- Do a physical exam.
- Do tests, such as:
- X-ray]]>—a test that uses radiation to take a picture of structures inside the body, especially bones and joints
- ]]>MRI scan]]>—a test that uses magnetic waves to make pictures of structures inside the body to check for damage to bones or joints
- ]]>Electromyography]]> (EMG)—a test that measures and records the electrical activity of a muscle
- ]]>Nerve conduction study]]>—a test that measures the speed and strength of electrical activity in a nerve
Talk with the doctor about the best treatment plan, which may include:
- Physical therapy and activity—This can help keep your baby’s joints and muscles flexible and strong. You will take an active role in moving your baby’s shoulder, arm, and hand. Massage may also be an option.
- Surgery—This may be recommended in cases where there is no improvement.
When your child is older, other treatments may be recommended, such as:
- Muscle and tendon transfer (surgery to improve function)
- Joint fusion surgery
American Academy of Orthopedic Surgeons
American Academy of Family Physicians
Canadian Orthopaedic Association
Society of Obstetricians and Gynaecologists of Canada
Brachial plexitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 30, 2009. Accessed February 8, 2010.
Brachial plexus injuries. Mayo Clinic website. Available at: http://www.mayoclinic.org/brachial-plexus/erbs-palsy.html. Accessed February 9, 2010.
Erb’s palsy. Patient UK website. Available at: http://www.patient.co.uk/showdoc/40001379. Accessed February 8, 2010.
Erb's palsy (brachial plexus birth injury). American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00077. Updated October 2007. Accessed February 8, 2010.
Last reviewed March 2010 by ]]>Robert E. Leach, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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