Erb’s palsy is a nerve injury that may occur at any time, but the vast majority of cases are the result of some complication during childbirth. Few events in life can be as heart-wrenching as the birth of a child with a serious medical condition. It is imperative that you learn exactly what happened so you may explore treatment options.
The Anatomy of Erb’s Palsy
Specifically, Erb’s palsy is what is considered a brachial plexus injury. The brachial plexus is a series of nerves to the arm, hand, and fingers that pass from the spinal cord, between the bones of the neck (vertebrae) and go into the arm. Along the side of neck, these nerves merge together. The nerves that go to the shoulder lie higher in the neck than those that go to the hand and the fingers.
Most cases of birth brachial plexus palsy affect the upper nerves. The condition was first identified by Wilhelm Erb and is known as Erb’s palsy.
The Causation of Erb’s Palsy
The primary cause of Erb’s Palsy at childbirth is when the shoulder of the child gets stuck behind part of the mother’s pelvis bone. This may be due to a large baby, a breech presentation or a prolonged labor.
Also, this may occur if the birth becomes difficult, and the person assisting in the birth deems it necessary to deliver the baby quickly. If an exertion of force is applied to pull the child from the birth canal, one side of the neck can be stretched, which in turn can also result in the stretching of the nerves. If this occurs, the network of nerves that comprise the brachial plexus can be damaged. .
The Effects of Erb’s Palsy
In general, there are four different types of nerve damage, which determine the severity of the condition and dictate treatment options:
• Neurapraxia, which is best characterized as a stretch injury that does not tear the nerve. Stretch injuries have a relatively high probability for healing without treatment, often within three to six months.
• Neuroma is a stretch injury that involves some damage to the nerve, typically creating scar tissue that presses up against the healthy nerve tissue.
• Rupture occurs when the stretching causes the nerve to be torn apart.
• Avulsion is the term used when the nerve is torn from the spinal column.
The Prognosis for Sufferers of Erb’s Palsy
Each child is unique; some symptoms are mild and recovery is quick, but in other cases there may be a total inability to use the hand, arm or shoulder and there is no reasonable potential for recovery. Rupture and avulsion are the most serious injuries. In some cases, a rupture can be repaired by essentially splicing a donor nerve graft from another nerve in the child’s body. There are currently no treatment options for repairing an avulsion.
As bad as it is to learn your child has a birth injury, it is worse to learn it could have been prevented. No one wishes to think of litigation adding to the burdens of dealing with a child with a serious injury, but you owe it to yourself and your child to understand whether medical malpractice may have played a role. Be sure you get the facts, explore your options and do what’s right for your child.