The brachial plexus consists of nerves that run from the spine to the shoulder and down through the tips of the fingers. Erbs palsy is a brachial plexus injury that causes paralysis of any or all of the muscles that control the shoulders, hands, or arms. The level of disability for a child with Erbs palsy depends on the location and severity of the injury.

Effects

This type of injury affects children in several different ways. Some children cannot use their elbow or shoulder muscles very well. Some cannot control their hands and wrists, but they can control their arms. Others have no feeling or muscle control in the hands or arms. The symptoms of this condition range from temporary motor paralysis to a complete loss of function.

Causes of Erbs Palsy

This condition can affect a child at any time, but it most commonly occurs during birth. In some cases, the baby's shoulder gets caught behind part of the mother's pelvic bone. This compresses the brachial plexus, causing stretching or tearing. Babies with high birth weights have an increased risk of this type of injury, but even premature babies can develop Erbs palsy. Injuries may be more severe in larger babies, as they have a greater chance of getting caught behind the bone. Approximately one or two babies in 1,000 develop Erbs palsy. They may experience a lack of muscle control in the arms or hands, limp arms, or paralyzed arms.

Types of Erbs Palsy

This type of injury is classified as one of four different types. Neuroma injuries may require surgery to restore normal function. These injuries occur when scar tissue compresses the nerves of the brachial plexus. Stretch injuries cause swelling and bruising. They may also cause nerve compression. These are the mildest type of this injury, with nearly complete function returning in approximately one to two years. Avulsion injuries are very severe, as they occur when the brachial plexus nerves are pulled from the spinal cord. This type of injury requires surgical intervention and may even require a muscle transfer to restore some of the lost function. Ruptures occur when the nerves are torn in several places. These injuries require physical therapy and surgery to restore function.

Diagnosis

Diagnosing Erbs palsy is not as easy as it might seem. Different injuries cause similar symptoms, making it difficult to diagnose the correct type of injury. In some cases, several brachial plexus nerves are damaged, which makes diagnosing the problem more complicated.

Recovery

Mild cases of Erbs palsy usually resolve within three to four months. Severe injuries need anywhere from 18 to 24 months to improve. Physical therapy that includes electrical muscle stimulation and range-of-motion exercises can prevent muscle wasting and keep the joints from getting stiff. Children with Erbs palsy may also need surgery or occupational therapy.