• Erb Palsy

    (Erb-Duchenne Paralysis; Brachial Plexus Palsy)

    Definition

    Erb palsy weakness or paralysis in the arm that is usually noticed after birth.
    Vaginal Birth
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    Causes

    Erb palsy is caused by stretching of the baby’s neck during labor and delivery. This can result in 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.
    Stretching may be caused by:
    • Long, difficult delivery
    • Delivery of a large baby
    • Shoulder dystocia
    • Breech delivery

    Risk Factors

    Factors that may increase your chance of delivering a baby with Erb palsy include:

    Symptoms

    Often, Erb palsy is discovered after birth due to the typical signs and symptoms, such as:

    Diagnosis

    You may be asked about your baby's symptoms and medical history. A physical exam will be done. Other tests may include:
    Your baby may need imaging tests. This can be done with:
    Your baby may need to have muscle and nerve activity recorded. This can be done with:

    Treatment

    Over time, the baby can recover movement. Feeling in the arm can also be recovered. In some cases, long-lasting damage can occur.
    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 palsy:
    • 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

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    Ortho Info—American Academy of Orthopedic Surgeons http://orthoinfo.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 Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T900412/Brachial-plexopathy. Updated June 12, 2015. Accessed September 29, 2016.

    Erb’s palsy. Patient UK website. Available at: http://patient.info/doctor/erbs-palsy-pro. Accessed June 13, 2017. Updated November 9, 2017.

    Erb's palsy (brachial plexus birth injury). Ortho Info—American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00077. Updated October 2014. Accessed November 9, 2017.

    Revision Information

    • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
    • Review Date: 11/2017
    • Update Date: 12/20/2014
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