Erb’s Palsy
(Erb-Duchenne Paralysis; Brachial Plexus Palsy)
Definition
Erb’s palsy happens when a baby’s neck is stretched during labor and delivery. This can cause damage to the upper nerves of the neck and shoulder. The nerve damage can then cause certain muscles in the baby’s arm to be weak. Over time, the baby can recover movement. Feeling in the arm can also be recovered. In some cases, long-lasting damage can occur.
Vaginal Birth
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Causes
Erb’s palsy is usually caused by:
- Long, difficult delivery
- Delivery of a large baby
- Shoulder dystocia
- Breech delivery
Risk Factors
Factors that increase your chance of delivering a baby with Erb’s palsy include:
- History of delivering larger babies
- History of prolonged labor
- Gestational diabetes
Tell your doctor if you have any of these risk factors.
Symptoms
Often, Erb’s palsy is discovered after birth due to the typical signs and symptoms, such as:
- Inability of your baby to move an arm or shoulder
- Arm is bent inward toward the body
- Weak or absent reflexes in the arm
- Loss of feeling in the arm
Diagnosis
The doctor may ask about your baby's symptoms and medical history. A physical exam will be done. Other tests may include:
- Your baby may need to have muscle and nerve activity recorded. This can be done with:
Treatment
Talk with the doctor about the best treatment plan, which may include:
- Physical therapy—This can help keep your baby’s joints and muscles flexible and strong. You will take an active role in moving your baby’s shoulder, arm, and hand. Massage may also be an option.
- Surgery—This may be recommended in cases where there is no improvement.
When your child is older, other treatments may be recommended, such as:
- Muscle and tendon transfer surgery to improve function
- Joint fusion surgery
Prevention
To help reduce your baby’s chance of Erb’s Palsy, take the following steps:
- Have regular prenatal care visits.
- Tell your doctor if you have had previous difficult deliveries.
- Follow your doctor's instructions if you are diagnosed with gestational diabetes.
RESOURCES:
American Academy of Orthopedic Surgeons
http://orthoinfo.aaos.org
American Academy of Family Physicians
http://familydoctor.org
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org
Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org
REFERENCES:
Brachial plexopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 19, 2012. Accessed March 13, 2013.
Erb’s palsy. Patient UK website. Available at: http://www.patient.co.uk/showdoc/40001379 . Updated January 22, 2010. Accessed March 13, 2013.
Erb's palsy (brachial plexus birth injury). American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00077 . Updated December 2010. Accessed March 13, 2013.
Last reviewed March 2013 by Andrea Chisholm, MD
Last Updated: 03/15/2013