overview
What is Erb's palsy?
Erb's palsy is a nerve disorder in the shoulder and arm that causes weakness or loss of muscle function. The brachial plexus is a group of five nerves that connect the spine to the arm and hand. These nerves allow your shoulder, arms, and hands to feel and move. When these brachial plexus nerves are not working well due to stretching or tearing, it is called brachial plexus palsy. Erb's palsy is the most common form of arm plexus paralysis. It affects the upper nerves in the plexus. Paralysis is another name for partial or complete loss of muscle function - muscle weakness orparalysis.
Erb's palsy is also known as Erb-Duchenne's palsy.
What types of injuries are common in Erb's palsy?
There are four types of brachial plexus injuries:
- Avulsion is when the nerve tears from the spine and is the most severe form of Erb's palsy.
- Rupture is when the nerve is torn but not from the spine.
- Neuroma is when the nerve is torn and healed but has left scar tissue. The scarred tissue puts pressure on the injured nerve and prevents it from sending signals to the muscles.
- Neurapraxia is when the nerve is stretched but not torn. Neurapraxia is the most common type of brachial plexus injury.
Who Does Erb's Palsy Affect?
Newborns sometimes develop Erb's palsy during a difficult vaginal birth or even during oneCaesarean section. During delivery, your doctor will sometimes need to move your baby's head to the side to make room for the delivery of their shoulders. In some cases, the stretching of the nerves causes damage, possibly even tears. This type of Erb's palsy is also called brachial plexus obstetric palsy, obstetric plexus palsy, or brachial plexus obstetric injury.
Erb's palsy can also happen to adults with traumatic injuries.
How common is Erb's palsy (birth paralysis of the brachial plexus) in newborns?
Erb's palsy occurs in 0.9 to 2.6 in 1,000 live births, or nearly 12,000 cases per year. It is most common in larger infants who need to be pulled out during labor because they are stuck.
symptoms and causes
What are the signs and symptoms of Erb's palsy?
Erb's palsy affects the shoulder, arm, and elbow. Generally, your hand muscles are not affected, but your hands may feel tingling or numbness.
Signs and symptoms of Erb's palsy include:
- Paralysis or flaccidity of the shoulder, arm, and elbow.You cannot lift your arm away from your body or bend your elbow.
- deafnessor tingling in your arm or hand.These are also known as "burners and stingers".
- A hand position known as "waiter's tip."The palm faces backwards and the fingers curl.
What Causes Erb Palsy in Newborns?
A newborn can develop Erb's palsy during birth. Sometimes your doctor may need to move your baby's head to the side during labor to get the shoulders out. The brachial plexus nerves from the neck to the shoulder can stretch or even tear. A newborn can also develop Erb's palsy because of the way it lay in the uterus during pregnancy and after labor has started.
What Causes Erb's Palsy (Brachial Plexus Injuries) in Adults?
Traffic accidents, mostly involving motorcycles, are the most common cause of brachial plexus injuries in adolescents and adults. Other causes of these injuries include gunshot or knife wounds, work-related injuries, accidents involving contact sports such as soccer, surgical complications, or tumors. These types of injuries are more likely to occur in men.
diagnosis and testing
How is Erb's palsy diagnosed?
Diagnosis usually begins with a physical exam. Your healthcare provider may also order these tests:
- EMG(electromyography).This test finds out how well muscles and nerves are working.
- Imaging tests.These tests take pictures of what is happening inside your body. Your provider can order oneMRTor aCTcombined withMyelogramm. Your provider could also order oneX-rayif there is any questionbroken bones.
management and treatment
How is Erb's palsy treated?
Treatment for Erb's palsy depends in part on how severe the injury is. Some cases resolve on their own within three to four months. But most likely, your doctor will suggest that you start exercise and physical therapy with your baby from around three weeks of age.
The range of motion and stretching exercises will help prevent stiffness in your baby's arm, hand and wrist. You should avoid joint contracture (permanent joint stiffness). Follow your provider's instructions for how often to do the moves each day.
Hydrotherapy combines exercise with water. The water provides support that makes the workout less painful.
Your provider maybeInjection of botulinum toxin (Botox®)paralyzing working muscles for a period of time to force weaker muscles to take over. You can also splint your baby's hand to prevent them from curling inward and being stiff.
If the paralysis hasn't improved before your baby is 6 months old, your provider may recommend surgery, including:
- nerve repair.These surgeries include nerve transplants, nerve transfers, neurolysis, and nerve decompression.
- muscle repair.It involves a muscle or tendon transfer to replace the damaged tissue with tissue from elsewhere in the body.
It's important to realize that any type of nerve repair and regrowth is slow—the results aren't immediately visible.
prevention
How can I reduce the risk of my newborn having Erb's Palsy?
There are certain risk factors associated with shoulder dystocia (a baby's shoulder is stuck in the mother's pelvis, which is related to Erb's palsy). These factors include:
- High birth weight of the infant and/or one parent in the pregnancy is overweight/obese.
- Diabetesin the pregnant parent (either pre-pregnancy diabetes or gestational diabetes).
- A previous pregnancy with shoulder dystocia.
- Being pregnant with more than one baby.
- Medications such as oxytocin or an epidural during labor.
- breech position at birth(Your baby is not head first in the birth canal).
How can an adult reduce their risk of Erb's palsy?
You may be able to reduce your risk of developing a brachial plexus injury by wearing protective gear when playing contact sports or riding a motorcycle.
Outlook / Forecast
What can I expect if I have Erb's Palsy or if my child has Erb's Palsy?
Some cases of Erb's palsy resolve on their own. Other cases respond so well to early treatment that the shoulder and arm move normally.
If someone with Erb's palsy doesn't recover early and doesn't have corrective surgery, they'll likely find that their arm and shoulder don't move normally later on.
There are relief organizations for people with Erb's palsy and their families. It may be helpful to contact these groups.
Is Erb's Palsy Fatal?
No, Erb's palsy is a nerve disorder that causes weakness or loss of muscle function in your arm or shoulder. It's not deadly.
to live with
When should I see my doctor for Erb's Palsy?
The longer a nerve injury goes untreated, the more difficult it can be to achieve optimal outcome. Therefore, it is important to see a specialist early on who can accompany you or your child to monitor your recovery and determine if an intervention is needed.
If you are the parent of an infant with Erb's Palsy, you will likely have follow-up visits. It is important to keep these deadlines. However, if something gets worse outside of these appointments, call your child's provider.
That applies if you are an adult with Erb's palsy. Let your doctor know if anything seems worse, if you have problems with the exercises, or if you have any other concerns.
frequently asked Questions
What is the difference between Erb's palsy and Klumke's palsy?
The two conditions are similar in that they are brachial plexus injuries. However, the nerve damage in Erb's palsy affects the upper nerves and affects your arm. The nerve damage in Klumke's palsy affects the lower nerves. The nerves of the inferior brachial plexus act on the muscles of the forearm and hand. Sometimes the hand looks like a claw. Klumke's palsy is also known as Klumke-Dejerine's palsy or paralysis.
A note from the Cleveland Clinic
Erb's palsy is the name for a specific type of injury to the nerves of the brachial plexus. It is most common during childbirth, but adults can get it too. The injury affects the movement of your shoulder and arm - they could be paralyzed. However, many infants with this condition can recover on their own. If your baby doesn't recover right away, discuss your concerns with your doctor. Make sure you know exactly how to do the exercises your doctor suggests. Do them on the right schedule and stick to your deadlines.