Erb’s Palsy

What is Erb's Palsy?

Erb's palsy is an injury to the brachial plexus nerves in infants, resulting in weakness or paralysis of the shoulder muscles. The brachial plexus is a group of nerves that start at the neck and travel along the spinal cord to the hands. Other nerves of the arm can also be injured at the same time.

What Causes Erb's Palsy?

Erb's palsy is generally caused by stretching of the nerves at the shoulder, neck, and arm during delivery. The following symptoms are signs that an infant may have Erb's palsy: a limp arm, no muscle control, and a loss of sensation in the arm.

Erb's palsy can be caused by one of four types of injuries to the nerves. The first type is called avulsion. This is when the nerve completely separates from the spine. The second type is rupture, where the nerve is torn throughout, but not at the spine. The third type of injury is called praxis/stretch. Here the nerve is not torn, but is damaged. It is possible for this type of injury to heal on its own. The last type of injury is called neuroma. This occurs when pressure is put on the nerve from scar tissue that has built from the original injury. This prevents the nerve from sending messages from the spine to the hands. Brachial plexus injuries cause suffering in one or two people in 1000. 10% of these require treatment.

How is Erb's Palsy Diagnosed?

The diagnosis is based on the physical examination and certain tests. These tests usually consist of nerve conduction studies and EMG, and anatomic studies, such as an MRI or CT – myelogram.

How is Erb's Palsy Treated?

Treatment is started a few days after Erb's palsy is diagnosed. It includes physiotherapy, exercise, therapy, and may include surgery. Recovery can be complete; most infants have recovery to some degree. The majority of recovery takes place within the first few months. However, 2 out of 10 infants with Erb's palsy will maintain some paralysis.

For More Information

National Organization for Rare Disorders (NORD): www.rarediseases.org

National Brachial Plexus/Erb's Palsy Association, Inc: www.nbpepa.org

United Brachial Plexus Network: www.ubpn.org

Erb's Palsy Association of Ireland: www.erbspalsy.ie

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