Erb's Palsy: Types, Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Erb's palsy is a neurological condition that affects the arms and shoulder, resulting in weakening or loss of muscle function. The brachial plexus, which connects the hand and arm to the spine, is made up of five nerves. These nerves allow your hands, arms, and shoulders to have sensations and movement. 

The condition caused by these brachial plexus nerves being stretched or ruptured is known as brachial plexus palsy. The most prevalent type of brachial plexus palsy is Erb's palsy. It affects the upper nerves of the plexus. Palsy is another word for a partial or whole loss of muscle function, which includes paralysis and muscular weakening.

Erb-Duchenne paralysis is another name for Erb's palsy.

Types Of Erb's palsy

The brachial plexus can sustain damage in four different ways:

• Avulsions, a condition in which the nerve tears away from the spine—are the most dangerous kind of Erb's palsy.
• Ruptures of nerves occur external to the spinal column.
• A repaired, torn nerve with residual scar tissue is called a neuroma. Because of the scarred tissue, the injured nerve is unable to transmit signals to the muscles.
• Neuropraxia is defined as nerve stretching but not nerve tearing. Neuropraxia is the most common type of injury to the brachial plexus.

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Causes Of Erb’s Palsy

Erb's palsy can occur in a newborn during delivery. To get your baby's shoulders out during delivery, your healthcare professional may occasionally need to turn your baby's head to one side. It is possible for the brachial plexus nerves to stretch or even tear from the neck to the shoulder. The position in which a baby is placed in the uterus both throughout pregnancy and after labor starts can also cause Erb's palsy in newborns.

For both adults and teenagers, brachial plexus injuries are most frequently caused by traffic accidents, particularly those involving motorbikes. These injuries can also result from gunshot or knife wounds, industrial mishaps, contact sports accidents e.g., football, surgical complications, or tumors. These kinds of injuries are more frequent in men than in women.

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Which signs and symptoms accompany Erb's palsy?

Erb's palsy affects the arm, shoulder, and elbow. The muscles in your hands are usually unaffected, even though they may feel tingly or numb.

The following are the signs and symptoms of Erb's palsy:

• There is paralysis or limpness in the elbow, arm, and shoulder. You can't lift your arm above your body or bend your elbow.
• Your hand or arm is tingling or numb. Another term for these is "burners and stingers.
• "The waiter's tip" position of the hand is referred to this condition. With the palm facing back and the fingers curled, hold out your hand.

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Risk Factors Of Erb’s Palsy

Many risk factors have been associated with shoulder dystocia, a disease related to Erb's palsy in which the baby's shoulder becomes trapped in the mother's pelvis. These components include:

• High birth weight and/or an obese or overweight pregnant mother.
• Diabetes in the expecting parent (either pre-existing or due to gestation).
• A previous pregnancy with shoulder dystocia.
• Twin pregnancy
• Taking oxytocin or receiving an epidural during giving birth.
• Breech presentation of the child

How is Erb's palsy diagnosed?

Typically, a physical examination is the initial step in the diagnosis procedure. Your healthcare practitioner may also ask for the following tests:

EMG stands for electromyography. This test evaluates how well the muscles and nerves work.

Imaging examination: Images of internal organ function are obtained during these procedures. Your physician may also recommend a myelogram in addition to an MRI or CT scan. Your healthcare professional may also ask for an X-ray if they are unsure if you have broken bones.

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How is Erb's palsy Treated?

Part of the treatment for Erb's palsy depends on the degree of the lesion. It takes three or four months for such injuries to go better on their own. However, your healthcare provider would likely encourage you to begin physical therapy and activities with your child at three weeks of age.

Preventing your baby's arm, hand, and wrist from stiffening up can be achieved with range-of-motion exercises and stretching. You want to avoid developing a joint contracture, which is an ongoing stiffness in the joint. Regarding how often you should move each day, take the advice from your doctor.

Hydrotherapy is the combination of exercise and water. The help provided by the water reduces the pain associated with exercise.

Your doctor may inject botulinum toxin, commonly known as Botox, to temporarily paralyze functional muscles and encourage weaker muscles to take over. They may also splint your baby's hand to prevent it from curling inward and stiffening.

Your baby's doctor may recommend surgery if, by the time they are six months old, their palsy has not improved. This procedure could include:

• Nerve repair: Neural grafts, transfers, neurolysis, and decompression are some of these surgical techniques.
• Muscular repair: A muscle or tendon transplant from another part of the body is used to replace the damaged tissue.

It is important to remember that nerve regeneration and repair, in whatever form, are progressive processes that do not produce immediate results.

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