Oklahoma Erb's Palsy
Erb's Palsy is a paralysis or weakness of the arm caused by an injury to one or more nerves that control and supply the muscles of the shoulder and upper extremities (known as the upper brachial plexus).
The paralysis can result from injury if a baby is trapped by its shoulder behind the mother's pelvis after the head been delivered. Fragile nerves in the child's neck and arm may be over-stretched or torn from the spinal cord in the effort to deliver the baby.
There are three main categories of injury:
Erb's Palsy
Outward signs include the arm turned towards the body, the elbow unable to bend and the hand permanently turned backward.
Klumpke's Palsy
Outward signs include the hand being limp, the fingers not moving and often an associated Horner's Syndrome1.
Complete Brachial Plexus Paralysis
The entire arm from the shoulder down is paralysed and often there is an associated Horner's Syndrome1. Demonstrable sensory loss in the arm as well as an associated Torticollis2.
Obsterical Erb's Palsy primarily occurs as a result of trauma at birth. While large babies are more likely to develop shoulder dystocia because their shoulders become trapped under the pubic bone, most cases of Erb's Palsy do not occur in large babies.
Excessive stretching of the head from the shoulder places tension on the brachial plexus, resulting in stretching or tearing of the nerve fibers, and with extreme force may rupture the nerves entirely or tear them from the spinal cord.
Approximately 80 percent of victims recover in the first three months, but the other 20 percent will have some residual paralysis. The ability to recover largely depends on the extent of injury.
While some brachial plexus injuries may heal on their own and many children improve or recover by 3 to 4 months of age.
1Horner's Syndrome is when the eyelid droops, the cheek does not sweat and the pupil is smaller than the unaffected eye.
2Torticollis is when the baby faces toward his good side and is unable to face forward for any length of time.
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