Contiditions Related and Similar to Cerebral Palsy

What is Erb's Palsy?

Erb's palsy specifically refers to injury of the C5 and C6 cervical nerves, but the term is often used to describe several different paralyses of the arm. The condition occurs during delivery when a baby's head is caught behind the mother's pelvic bone and must be pulled from the birth canal. A parent will notice a child has Erb's palsy almost immediately because one arm will either be paralyzed of have less movement than the other. The paralysis indicates the brachial plexus nerve has been injured.

What Causes Erb's Palsy?

Erb's palsy typically affects children with high birth weight. A baby grows so large in the womb that it is difficult to pass through the birth canal. Sometimes the head is partially delivered, but the baby's shoulder gets stuck. The person delivering the baby twists the head, exerts excessive force to pull the baby out or uses assistive devices to complete delivery. The process stretches or tears the upper nerves of the brachial plexus resulting in partial or total paralysis of the arm.

The nerves which control the fingers, hand and arm begin in the spinal cord, extend though the vertebrae of the neck and descend into the arm below the collarbone. Arm nerves leave the spinal cord from high in the neck. Nerves controlling the hand and fingers exit the spinal cord just above the chest. Both sets of nerves meet in an area near the neck and shoulder joint called the brachial plexus. This is the area where the nerve tearing or stretching causing Erb's palsy occurs. Depending on injury severity a baby may be able to move their fingers but not their arm.

Treatment for Erb's Palsy

80% of babies with Erb's palsy recover before their first birthday. A doctor will gauge the child's recovery by measuring muscle contraction in the baby's arm. Doctors expect full recovery if the child can begin contracting the deltoid and bicep by one month after birth. Prognosis is good for recovery if the child can contract the muscles slightly by the end of the first 3 months and completely by 5 months. Full recovery depends upon the severity of the injury; whether the nerves were merely bruised, stretched or completely torn.

If there is no change in the baby after 3 months most doctors will consider surgery. Surgery usually works best for a child under the age of one year old. Any older and doctors don't expect the child will regain full use of the arm. Sometime physical therapy is helpful after surgery in speeding recovery. Children with Erb's palsy continue to have arm weakness after surgery because nerves only grow at a rate of one inch a month. It takes time for nerves repaired at the brachial plexus to regenerate down into the fingers.
If nerves are only partially repaired, the child can expect to have difficulty in turning the palm up, raising their hand above their head or with wrist extension. Physical therapy can be helpful in these instances.

Erb's Palsy Statistics

* 1 to 2 children out of every 1,000 born in the United States are affected by Erb's Palsy
* Almost 80 % of Erb's palsy cases heal unassisted before the child turns 1 year old
* 20 % of children with Erb's palsy will have some paralysis of the arm
* Babies weighing over 8 pounds have a higher risk of Erb's palsy
* Erb's palsy accounts for approximately 60 percent of all brachial plexus injuries