Erb’s palsy, also known as Erb-Duchenne palsy refers to a medical condition that results in the paralysis of the arm. It is most commonly seen in infants born under difficult or abnormal conditions.
Erb’s palsy is a variant of obstetric brachial plexus disorder, a type of injury that results when the nerves of a baby’s arm get damaged. This typically happens when the neck of the infant is stretched to one side during the delivery process.
The brachial plexus is an elaborate system of nerves that runs down along the spine and gives feeling to the nerves of the arm. These nerves are responsible for controlling the muscles of the hands, shoulders, wrists and elbows, apart from providing feeling and movement. When the upper nerves are damaged during the birth of the child, the child’s development can get delayed and result in permanent damage.
Due to symptoms such as paralysis and nerve damage, the condition is often confused with cerebral palsy. However, there are certain significant distinctions from conditions like cerebral palsy and other movement disorders. When the paralysis causes loss of voluntary movement in the upper arm and affects the rotation in the lower arm, the condition is called Erb’s palsy.
Types of Erb’s Palsy Injuries
Classifying the different types of Erb’s palsy can be extremely difficult as the classification is mostly dependent upon the degree of the damage caused to the brachial plexus nerve.
These are the main types of nerve injuries that are observed in Erb’s palsy:
These are also called burners or stingers and are the most common type of neural injury. Neuropaxia is usually seen when the nerves are shocked or stretched, but do not tear or have any lasting damage. The symptoms may include burning or shocking sensations which shoot up and down the affected nerve. The symptoms usually ease in about 3 months.
These are slightly more serious stretch injuries. They cause damage to nerve fibres and result in the formation of scar tissue on healing. The scar tissue ends up causing pressure on the nerve due to which only partial recovery is possible from neuromas.
A rupture is a stretch injury in which the nerve tears completely. This type of injury almost always requires a surgical process wherein a spliced nerve from a different part of the newborn’s body is taken and grafted to the site of the rupture.
An avulsion is when the nerve is torn apart completely from the spinal cord. Avulsions are notoriously difficult to heal, even with surgical intervention, but grafting a nerve from a healthy part to the affected part may sometimes help to restore some degree of arm function.
Symptoms of Erb’s Palsy
The major symptoms of Erb’s palsy include weakness, favouring of one arm over the other or in severe cases, paralysis of the limb. The severity of the condition varies from soreness and weakness to partial or total paralysis.
Some of the symptoms to watch for include:
- The affected arm may be contorted, held limply to the side or bent.
- Reduced grip power of the affected hand.
- Loss of sensory and/ or motor function in the upper arm on the affected side.
- Impairment of circulatory, nervous and muscular development.
- Partial or complete paralysis of the arm.
Main Causes And Risk Factors Of Erb’s Palsy
Erb’s palsy is mostly caused due to excessive stretching or pulling of the infant’s head and shoulders during vaginal birth. It also occurs when the head is stuck in the birth canal and the mid- wife is forced to pull out the child, either in head-first deliveries where the pressure is on the shoulders, or in feet-first deliveries where the pressure gets exerted on the raised arms of the infant.
It also occurs if the infant is larger with broad shoulders. In some cases, the head comes out through the birth canal, but one shoulder gets stuck against the pubic bone of the mother. As the infant’s head is pushed lower by natural contractions, the nerves get stretched which results in Erb’s palsy.
Additional risk factors include use of extraction tools during childbirth, large infant size and excessive weight gain of the mother.
Treatment of Erb’s palsy usually requires the efforts of cross-functional teams which include neurologists, neurosurgeons, physiotherapists and orthopaedic surgeons.
Treatment options include physical therapy, occupational therapy and surgery. Physical therapy is used for most mild cases with the therapist employing gentle massages and exercising techniques to improve movement in nerves and muscles to improve stiffness and mobility.
Occupational therapy is used if the child shows no improvement even after 2-4 months. A variety of movement exercises are used to improve muscle tone and joint function so as to give the child strength to perform everyday activities like picking up toys and bottles.
Surgery is employed for severe cases to address paralysis and nerve damage. Exploratory surgery is used to remove scar tissue from neuromas and grafting is used to repair nerve ruptures. Combined with physical and occupational therapy, it goes a long way in improving the condition of severely affected infants.
Claiming Compensation For Erb’s Palsy
If your child has been diagnosed with Erb’s palsy, chances are the injury occurred during the time of delivery and you may be eligible to file a Erb’s palsy medical negligence claim. Because of the many complications involved, it is advisable to seek expert legal advice about your child’s rights and how to proceed with the claim.
Our personal injury solicitors offer a free consultation, during which they will hear you out and weigh the merits of your claim. If you are eligible to claim, you will be assured to know we shall represent you on a No Win No Fee basis, so you do not have to worry about paying any legal fees at any point during the case. They will complete all court formalities and fight the claim on your behalf, so you can focus your time and finances on getting the medical treatment that you need for your child.
You are only liable to pay a fee only after the case is closed and the court has awarded you compensation. The amount you will need to pay at this time is a percentage of the total amount awarded to you as recompense which is no more than 25%.