Erb's Palsy
Erb's Palsy is a paralysis of the arm caused by injury to the upper group of the arm's main nerves, specifically the upper trunk C5-C6 is severed. These form part of the brachial plexus, comprising the ventral rami of spinal nerves C5-C8, and T1. These injuries arise most commonly, but not exclusively, from shoulder dystocia during a difficult birth. Depending on the nature of the damage, the paralysis can either resolve on its own over a period of months, necessitate rehabilitative therapy, or require surgery.
The most common cause of Erb's palsy is dystocia, an abnormal or difficult childbirth or labour. For example, it can occur if the infant's head and neck are pulled toward the side at the same time as the shoulders pass through the birth canal. The condition can also be caused by excessive pulling on the shoulders during a vertex presentation (head first delivery), or by pressure on the raised arms during a breech (feet first) delivery. Properly trained obstetricians will identify shoulder dystocia risks and take steps to avoid injury during delivery. Increased risk factors include:
- High birth-weight babies
- Maternal diabetes
- Overweight mothers
- Short maternal stature
- A contracted or flat pelvis
- A pregnancy lasting more than 40 weeks
- Protracted second stage labor
Symptoms of Erb's Palsy are usually very evident, even at first sight. In severe cases, his/her arm may lie useless at the baby's side with an extended and completely motionless elbow.
- Complete loss of muscle control and feeling in the arm or hand
- Limited ability to move, and but little control
- Hand function, but without shoulder or elbow function
- Paralysis of the hand and fingers
- Facial paralysis
- Ability to sit upright unassisted is not possible
- Loss of ability to crawl without therapeutic devices.
