Erb's palsy

Erb's palsy is a condition characterized by arm weakness and loss of motion. It can occur in both infants and adults. It's typically caused by a physical injury during newborn delivery or by traumatic force downward on the upper arm and shoulder, damaging the brachial plexus.Otherwise known as Brachial plexus

Injury to the upper trunK of brachial plexus causes Erbs 

Cause

Undue separation of the head from the

shoulder which is commonly

encountered in the following

1. Birth injury (Breech delivery)

2. Fall on the shoulder

3. During anaesthesia

Diagnosis

To determine if an infant or older patient has Erb’s palsy, a physician will perform a physical examination to evaluate arm weakness. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures may include:

Electromyogram (EMG): This test measures the electrical activity of a muscle in response to stimulation, as well as the nature and speed of the conduction of electrical impulses along a nerve. It can confirm the presence of nerve damage and assess its severity.

Imaging studies: The physician may order an X-ray, ultrasound or other imaging test to check for damage to bones and joints of the neck and shoulder.

Nerve conduction studies: These tests measure how well individual nerves can send an electrical signal from the spinal cord to the muscles.

A physician places a shock-emitting electrode directly over the nerve to be studied, and a recording electrode over the muscles supplied by that nerve. The shock-emitting electrode sends repeated, brief electrical pulses to the nerve, and the recording electrode records the time it takes for the muscle to contract in response to the electrical pulse

Signs and Symptoms

Erb's palsy symptoms will vary depending on the type of injury to the brachial plexus nerve.

Erb’s palsy symptoms in babies and adults include:

Loss of feeling in one arm

Partial or total paralysis of one arm

Weakness in one arm

Numbness in one arm

Limited motion

Prognosis

Mild to moderate cases of Erb’s palsy resolve within a few months. For 70 to 80 percent of affected infants, and in nearly 100 percent of patients if treatment begins within four weeks of birth, it will resolve in the first year of life

Complications

Most infants and older patients with Erb’s palsy will recover strength and movement in the affected arm.

Rarely, potential Erb's palsy complications that occur include:

The affected arm may grow to be slightly shorter

The affected arm failing to regain full strength or be unable to carry out circular movement

Nerve involved in Erb’s palsy 

1. Axillary nerve 

2. Suprascapular Nerve

3. Musculocutaneous Nerve

Muscle paralyzed

Mainly 

Biceps Brachii 

Deltoid 

Brachialis 

Brachioradialis 

Partly

Supraspinatus 

Infraspinatus 

supinator

Position of limb

Arm Hangs by the side, it is adducted&internal rotation 

Elbow in extension 

Forearm pronated & Extended

Palm facing Backwards

Treatment

Surged Faradic current

Interrupted galvanic current 

Prevention

Most cases of Erb’s palsy in infants can be prevented by:

Advanced planning: If the baby is larger than usual or in the incorrect position in the weeks leading up to the due date, advanced planning by the obstetrician to prevent Erb’s palsy should include ensuring qualified personnel are present in the delivery room, proper use of birthing instruments and extractors, and induction of labor or Cesarean delivery if several risk factors are identified.

Maternal healthcare: Good maternal healthcare during pregnancy, including avoidance or control of diabetes, can help prevent Erb’s palsy