What is a brachial plexus injury? What is Erb's Palsy?
Most people have never heard of the brachial plexus or Erb’s Palsy. If you are reading this, you may have a reason to know, and you would probably like to know more about whether medical malpractice might be the cause.
Babies or children who have weak, uncontrollable, or paralyzed arms, decreased feeling in an arm, or misalignments of the elbow, arm or shoulder may have suffered a brachial plexus injury and may have Erb’s Palsy. But what does this mean? Let’s examine three main terms involved in this type of injury. They are "brachial plexus", "shoulder dystocia", and "Erb’s Palsy".
The brachial plexus is an area of the neck where nerves are centralized. This network carries electrical signals from the brain, through the neck, down the arm, and into the fingers. Damage to this complex of nerves is called a brachial plexus injury. As with any injury, severity can vary. Injury to the brachial plexus can occur during vaginal delivery when this network of nerves is stretched or torn. Sometimes during birth a baby’s shoulder or shoulders will get caught behind a part of the mother’s pelvis. This is called "shoulder dystocia". If the doctor pushes, pulls, or twists the baby, the baby’s head, or the baby’s shoulders, the nerves of the brachial plexus can be stretched or torn.
Older children, teens, and adults, may suffer a brachial plexus injury in a car accident, while playing sports, or after other violent trauma. However, a newborn baby who suffers a brachial plexus injury is likely the victim of a doctor who committed malpractice by stretching or tearing the nerves. In many cases, a baby who suffers a brachial plexus injury during birth can recover within several months. In severe cases, where the nerves were completely severed or torn from the spinal cord, recovery is impossible. This condition is called "avulsion". Where the damage is permanent and the child suffers permanent and lifelong paralysis, weakness, and/or numbness, the condition is frequently also called "Erb’s palsy". The less severe, but still temporary or permanently debilitating injuries to this network of nerves are ruptures (nerves are torn, but not separated from the spinal cord), neuropraxia (the nerves are stretched, but not torn), and neuroma (scar tissue forms as a result of a stretch injury).
Treatment of a brachial plexus injury or Erb’s Palsy include physical therapy and surgery. Again depending upon the exact nature and severity of the injury, the condition may or may not be significantly improved. And in some cases, surgery will not reverse the injury to any degree.
Obstetricians understand the potential for a brachial plexus injury, and should take certain actions when certain medical signs and conditions are present before or during delivery. One option is a c-section. Another option involves employing known maneuvers to deal with shoulder dystocia while at the same time protecting the baby from brachial plexus injury. A reason that these types of injuries occur is that once the baby’s head is out, the baby wants to breathe. If the baby’s shoulder then gets stuck, the doctor may frantically try to deliver the rest of the baby. As a result, the doctor may twist, push and pull incorrectly, causing a brachial plexus injury. If the baby has difficulty breathing at this stage, the baby may suffer a loss of oxygen to the brain and may develop cerebral palsy. Click here to visit a brief article on cerebral palsy.
