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Erb's Palsy, also known as Erb's Palsy, is a condition that occurs due to nerve injuries around the time of birth, affecting the brachial plexus - the network of nerves near the neck that give rise to all the nerves of the arm. This condition can cause arm weakness, loss of motion, and in more severe cases, paralysis in the affected arm.
The brachial plexus is formed from the nerves that pass from the spinal cord, between the bones of the neck, and into the arm. This system of nerves travels behind the collarbone and spreads out into the arm, controlling movement and sensation in the shoulder, arm, and hand.
There are various types of nerve injuries associated with this condition, including neurapraxia, neuroma, rupture, and avulsion. Neurapraxia, the most common type, is a stretch injury that "shocks" but does not tear the nerve, and typically heals on its own within three months. Neuroma involves damage to some nerve fibers resulting in scar tissue, while a rupture is a more severe injury where the nerve is torn apart. Avulsion is the most severe form, where the nerve is torn from the spinal cord.
The causes of Birth Brachial Plexus Palsy in newborns often include difficult deliveries, such as those involving large babies, breech presentations, or prolonged labor. Sometimes, the condition may occur without any evident risk factors and can also happen in babies delivered via Caesarean sections.
Symptoms may include weakness in one arm, loss of feeling, or partial or total paralysis of the arm. Most infants with this condition will recover both movement and feeling in the affected arm, and physical therapy is an important part of treatment.
Diagnosis typically involves a physical examination by a pediatrician and may include imaging tests like X-rays, ultrasounds, or MRIs to assess any damage to the bones, joints, and nerves. The majority of babies with this condition recover within the first month to six weeks after birth, with ongoing exams scheduled to monitor progress.
Treatment can vary depending on the severity of the injury. Observation and physical or occupational therapy are common for less severe cases, to help maximize the use of the affected arm and prevent muscle and joint stiffness. In more severe cases, surgical options, including nerve and muscle repair, might be recommended.
Understanding and managing Birth Brachial Plexus Palsy is crucial for the health and development of the affected infants. Early diagnosis and treatment can significantly improve the outcome and reduce the risk of long-term complications.
The most common cause is shoulder dystocia during delivery—when the baby’s shoulder becomes stuck—leading to excessive stretching or tearing of the brachial plexus nerves. It can also occur during Caesarean sections or due to improper use of delivery instruments.
Symptoms include a limp or droopy arm, limited movement at the shoulder and elbow, and a “waiter’s tip” posture (arm hanging by the side, palm facing backward, elbow extended).
Diagnosis starts with a physical exam to assess strength, movement, and sensation. Additional tests may include electromyography (EMG), MRI, CT myelograms, or ultrasound to evaluate nerve damage.
Physical and occupational therapy with gentle exercises, stretching, and stimulation to improve muscle strength and mobility. Surgery, when needed, may include nerve grafting, nerve transfers, or tendon transfers. Early intervention usually leads to better outcomes.
Some risk factors—such as large birth weight, shoulder dystocia, breech delivery, or maternal diabetes—can increase the likelihood. Skilled delivery management, including prompt recognition and appropriate maneuvers or opting for C-section when needed, can reduce risk.
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Very good experience. The doctor is kind and clearly explained the treatment plan for our daughter's Erb's palsy. After surgery, we've seen major improvement in her hand movement.
Highly recommended for pediatric nerve issues. My son had no shoulder function at birth, but after treatment for Erb's Palsy, he's doing much better. Thank you, doctor!
We were really worried when we found out about our newborn's Erb's palsy. Dr. YV Rao explained everything with patience. Surgery and physiotherapy helped our child recover well
Our child had limited shoulder movement due to Erb's palsy. After nerve surgery at this clinic, we've seen excellent progress. The doctor was very supportive throughout.
My baby was diagnosed with Erb's Palsy at birth. We consulted Dr. YV Rao and started treatment early. The improvement in arm movement has been amazing. Grateful for the support and care.