What is Erb's Palsy

Erb's Palsy is a form of obstetric brachial plexus palsy characterized by weakness or paralysis of the arm, typically caused by injury to the upper nerves of the brachial plexus during childbirth. While most infants experience spontaneous recovery, some may require physical therapy or surgical intervention to regain full function.

What is the underlying cause of Erb's Palsy?

Erb's Palsy occurs when the C5 and C6 nerve roots in the neck are damaged. This most frequently happens during a difficult delivery, such as shoulder dystocia, where the infant's shoulder becomes lodged behind the mother’s pelvic bone. This stretching or tearing of the nerves disrupts the electrical signals between the spinal cord and the arm, leading to the characteristic muscle weakness associated with Erb's Palsy.

How common is this condition?

The incidence of Erb's Palsy is estimated to be between 0.5 and 2 per 1,000 live births. It is not a genetic or hereditary condition, but rather a mechanical injury occurring during the birth process. While there is no specific geographic concentration, risk factors include high birth weight (macrosomia), prolonged labor, and maternal diabetes.

What are the primary symptoms and classifications?

Symptoms of Erb's Palsy typically present immediately after birth. The arm may hang limply by the side, be rotated inward, and lack a Moro reflex on the affected side. Clinicians generally classify the severity of the nerve injury into four categories:

• Neuropraxia: A temporary nerve shock with a high rate of full recovery.


• Neuroma: Scar tissue that forms around the nerve, potentially impeding healing.


• Rupture: The nerve is torn and requires surgical repair to heal.


• Avulsion: The nerve is pulled completely from the spinal cord, requiring specialized surgical intervention.

How does Erb's Palsy differ from other conditions?

Unlike cerebral palsy, which is a brain-based motor disorder, Erb's Palsy is a peripheral nerve injury. It is also distinct from Klumpke’s palsy, which affects the lower nerves (C8-T1) of the brachial plexus, resulting in weakness in the hand rather than the shoulder and elbow.

Next steps

• Consult a pediatric neurologist or an orthopedic surgeon specializing in brachial plexus injuries.


• Begin early intervention physical therapy to prevent muscle contractures.


• Connect with the community at DiseaseMaps.org to share experiences with others.

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: Obstetric brachial plexus palsy.


• American Academy of Orthopaedic Surgeons (AAOS): Brachial Plexus Birth Palsy.