How do I know if I have Erb's Palsy?

Erb's Palsy is a brachial plexus injury typically occurring during childbirth, resulting in weakness or paralysis in the affected arm. You can identify Erb's Palsy by observing limited range of motion, a "waiter's tip" hand position, or muscle atrophy in the shoulder and upper arm compared to the unaffected side.

What are the primary signs of Erb's Palsy?

Erb's Palsy involves damage to the C5 and C6 nerve roots. In infants, the most common sign is a lack of movement in the upper arm while the hand and wrist remain mobile. If you are an adult or adolescent looking back at your medical history, you may notice persistent shoulder weakness, a difference in arm length, or restricted rotation of the arm. It is important to distinguish Erb's Palsy from typical joint stiffness or minor injury, as this condition is defined by a specific neurological deficit rather than temporary muscle fatigue.

How is Erb's Palsy diagnosed?

Diagnosis is based on physical examination and electrodiagnostic testing. Physicians look for specific patterns of motor loss, often using the following tools:

• Electromyography (EMG): Measures electrical activity in muscles to determine the extent of nerve damage.


• Nerve Conduction Studies: Assesses how well nerves transmit signals to the muscles.


• MRI or Ultrasound: Used to visualize the brachial plexus nerves and identify potential scarring or structural issues.

When should I seek urgent medical evaluation?

While Erb's Palsy is generally diagnosed at birth, you should consult a specialist if you experience sudden, unexplained worsening of arm weakness, chronic neuropathic pain, or significant loss of sensation. If you feel your concerns are being dismissed, advocate for a referral to a pediatric neurologist or a specialized brachial plexus surgeon. Bringing a detailed log of your range of motion limitations and any history of birth trauma can help your physician better understand your specific case of Erb's Palsy.

Next steps

• Schedule an appointment with a neurologist or an orthopedic surgeon specializing in peripheral nerves.


• Request copies of your birth records and early pediatric physical therapy reports.


• Connect with others at DiseaseMaps.org to share experiences and find support.


• Discuss physical therapy options to maintain muscle strength and joint flexibility.

Medical disclaimer: This content is for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD): Brachial Plexus Birth Palsy


• Orphanet: Erb-Duchenne palsy


• National Institute of Neurological Disorders and Stroke (NINDS): Brachial Plexus Injuries Information Page


• American Society for Surgery of the Hand (ASSH): Brachial Plexus Birth Palsy