Erb’s Palsy: Causes, Symptoms, Diagnosis, Treatment, and Prevention
An Erb's palsy is a neurological condition that causes weakness, paralysis, or loss of sensation in the shoulder and arm. Erb's palsy is usually caused by an injury at birth or later in life. This article will discuss its causes, symptoms, diagnosis, treatment, and prevention.
Causes of Erb’s Palsy
The brachial plexus connects the spine with the arm and hand, allowing the shoulder, arm, and hand to move and feel. Erb's palsy is caused by damage to the upper trunk of the brachial plexus.
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Neurapraxia: The nerve is stretched but not torn. This is the most common and least severe type of injury.
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Rupture: The nerve is torn but not detached from the spine. This is a more serious type of injury that requires surgery.
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Avulsion: The nerve is ripped away from the spine. This is the most severe type of injury that may not be repairable.
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Neuroma: The nerve is torn and healed, but scar tissue forms and puts pressure on the nerve. This type of injury may impair nerve function.
The most common cause of Erb’s palsy is a difficult or complicated delivery, especially when the baby is large, breech, or has shoulder dystocia (when the shoulder gets stuck behind the mother’s pelvis). As well as falling, accidents, sports injuries, and gunshot wounds, Erb’s palsy can also be caused by falls, accidents, sports injuries, or gunshot wounds.
Symptoms of Erb’s Palsy
The symptoms of Erb’s palsy depend on the type and severity of the nerve injury. The main symptoms are:
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Weakness or paralysis in the affected arm, shoulder, or hand
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Lack of movement or reduced range of motion in the arm, shoulder, or hand
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Decreased sensation or numbness in the arm, shoulder, or hand
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Pain or discomfort in the arm, shoulder, or hand
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Poor grip strength or difficulty holding objects
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Abnormal posture or position of the arm, such as inward rotation, wrist flexion, or finger extension
The symptoms of Erb’s palsy may be noticeable at birth or develop later in life. The symptoms may improve over time or persist for months or years.
Diagnosis of Erb’s Palsy
Doctors diagnose Erb's palsy by examining the baby's or child's arm for signs of nerve damage, such as muscle weakness, reduced reflexes, or abnormal movements. Erb's palsy may also be caused by a birth or an injury, which the doctor will ask about.
To confirm the diagnosis and assess the extent of the nerve damage, the doctor may order some tests, such as:
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X-rays: To check for fractures or dislocations in the shoulder or arm
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Ultrasound: To visualize the brachial plexus and the surrounding tissues
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Electromyography (EMG): To measure the electrical activity of the muscles
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Nerve conduction studies (NCS): To measure the speed and strength of the nerve signals
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Magnetic resonance imaging (MRI): To obtain detailed images of the brachial plexus and the spinal cord
Treatment of Erb’s Palsy
There are a number of treatment options for Erb's palsy, depending on the type and severity of the nerve injury, the patient's age, and the expected outcome. The main goals of treatment are to restore function, prevent complications, and improve quality of life.
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The best treatment for Erb's palsy is physical therapy. It involves exercises, massage, and stimulation in order to improve the strength, flexibility, and coordination of the affected arm, shoulder, and hand. As soon as possible after the diagnosis, physical therapy should begin and continue until a maximum level of recovery has been achieved.
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In occupational therapy, patients are able to use their affected arms, shoulders, and hands to perform daily activities, such as dressing, eating, or writing. Occupational therapy also provides adaptive devices, such as splints, braces, or slings, to support the arm and prevent contractures.
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Analgesics, anti-inflammatory medications, muscle relaxants, and nerve blockers are used to relieve pain, inflammation, or spasms in the affected arm, shoulder, or hand.
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As a last resort treatment when nerve injuries are severe or cannot be treated conservatively, surgery is considered. Nerve damage can be repaired or grafted, scar tissue can be released, or muscles or tendons can be transferred from one part of the body to another. Surgery is usually performed within the first year of life or before the age of five, when nerve growth potential is greater.
Prevention of Erb’s Palsy
Erb’s palsy is not always preventable, but some measures can reduce the risk of nerve injury during birth or later in life. These measures include:
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The prenatal care involves regular check-ups, screenings, and tests to monitor the health of the mother and the baby and to detect complications, such as fetal macrosomia, breech presentation, or gestational diabetes.
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Preparation for delivery: This involves discussing with the doctor the best mode and method of delivery, such as vaginal or cesarean, as well as the use of forceps, vacuums, and other instruments to avoid excessive traction or pressure on the baby.
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To prevent accidents or injuries that may affect the shoulder or arm, safety precautions include wearing protective gear, such as helmets, pads, or gloves, whenever you engage in sports or recreational activities that may involve falls or collisions, and following traffic rules and regulations when you drive or ride a vehicle.
