Birth injuries that result in serious conditions, such as Erb’s palsy, are devastating for the child and family. Tom Kiley discusses the causes, symptoms, diagnosis and treatment for Erb’s palsy. Contact Thomas M. Kiley & Associates at (800) 930-8145 if your baby has Erb’s palsy.

Overview of Erb’s Palsy

Improved techniques in the labor and delivery process have helped reduce the number of birth injuries that occur in the United States each year. Obstetricians still occasionally make mistakes that ultimately cause severe injuries to the newborn. Erb’s palsy, also referred to as Brachial palsy, Klumpke paralysis and Erb-Duchenne paralysis, is almost always caused by an injury that occurs during birth. It is also a condition that is often preventable when the appropriate measures are taken by doctors and hospital staff.

Erb’s palsy is defined as “a loss of movement or weakness of the arm caused by damage to the collection of nerves around the shoulder.” The bundle of nerves is called the brachial plexus. Depending on the extent of damage, the paralysis can eventually resolve itself or require physical therapy or even surgery.

Causes of Erb’s Palsy
Dysocia, which is an abnormal or difficult childbirth or delivery, is the most common cause of Erb’s palsy. For example, if the doctor pulls the infant’s head or neck toward the side as the shoulders pass through the birth canal, it can cause injuries to the infant. Erb’s palsy can also be the result of excessive pulling on the shoulders during a head first delivery or by pressure of the raised arms during a breech delivery.

There are factors that can increase the risk of a difficult delivery which could result in Erb’s palsy. These risk factors include:

• Prolonged labor
• Breech position
• Larger babies
• Induced labor
• Fetal position in the birth canal
• Mother who previously gave birth to a child with shoulder dystocia
• Mother has small pelvic outlet

Symptoms of Erb’s Palsy and Diagnosis
Paralysis can be either partial or complete and the damage to the nerves can range from bruising to tearing. The symptoms are typically noticeable immediately or soon after birth. According to MedicinelinePlus.com, some of the symptoms associated with Erb’s palsy include:

• Absent Moro reflex, also known as the startle reflex, on the affected side
• Arm flexed at elbow and held against body
• Decreased grip on the affected side
• Lack of spontaneous movement in the upper or lower arm or hand

Severely injured infants may even have a droopy eyelid on the side that was hurt. Erb’s palsy is frequently diagnosed through tests, such as an x-ray of the neck, CT scan or MRI scan if a collarbone fracture is suspected. The physician will also observe the infant’s arm position and movement.

Treatment for Erb’s Palsy
If the injury to the infant is mild, the condition should correct itself after several months. In the situation where the condition does not improve, surgery on the nerves may be recommended. Tendon transfers are occasionally used to compensate for nerves that are not functioning properly. Other treatment options include nerve transfers and subscapularis releases.

Most infants will heal within six months, but those who do not need additional surgery and treatments to balance the nerve deficits.

Compensation for Erb’s Palsy
If your child was injured during birth, which led to the development of Erb’s palsy, you may be entitled to compensation depending on the details of your case. Doctors, nurses and hospitals sometimes make errors that can result in birth injury. Contact Thomas M. Kiley & Associates at (800) 930-8145 for advice regarding your Erb’s palsy case.

©2009 Thomas M. Kiley & Associates, LLP, All Rights Reserved, Reproduced with Permission
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