Your child was born with Erb’s Palsy. You have a gnawing suspicion that something went wrong.
Was it just a difficult birth? OR…was it medical negligence?
Sometimes during labor and delivery, as the baby is descending down the birth canal to be born, the baby’s shoulder may get stuck on the mother’s pubic bone, and when the baby gets stuck, the doctor needs to get the baby out. So the doctor may put traction on the baby’s head and pull to try to deliver the baby. If the doctor uses too much traction or pulls too hard, that can damage the nerves in the brachial plexus. It can range from mild to pretty severe depending on the degree of stretching and it may even tear the nerves from the spinal cord and that causes an injury to the baby’s shoulder, to the baby’s arm, to the baby’s hand. So, the baby may have limited motion with that arm and with the hand.
Parents frequently want to know is this something that could have been prevented or the steps that could have been taken to avoid this injury to my child. One example would be maybe the baby was large and really shouldn’t have been delivered vaginally in the first place. Maybe a c-section would have been the appropriate way to deliver the baby or did the doctor used too much traction and pull too hard causing this injury to the baby’s nerves. So, if you have a child that has a brachial plexus injury, you should contact our firm and ask us these questions. We can review the medical records to see if we can help identify whether there was a medical error made which caused an injury there shouldn’t have been.
Erb’s Palsy Birth Injury Information
Was Your Child Born with Erb’s Palsy?
It is a frightening experience for parents when a child is born is born with Erb’s palsy. The baby’s arm hangs limply from the shoulder, with flexion (bending) caused by muscle weakness in the wrist and fingers. Erb’s palsy can occur when the newborn’s neck is stretched to the side during a difficult delivery, as stated by the American Academy of Orthopedic Surgeons (AAOS). It can also be caused by a doctor who applies excessive traction on the baby’s head while the shoulder remains stuck during delivery, injuring the neck and brachial plexus nerves.
The good news is that most children born with Erb’s palsy are able to make a complete recovery – 80% to 96%, as reported by Pediatrics & Child Health, particularly when the condition begins to improve within the first two weeks after birth. However, surgery may be needed to improve the outcome for infants who have not yet begun to recover in three to five months.
What are Brachial Plexus nerves?
The brachial plexus is a network of nerves located between the shoulder and the neck. The brachial plexus nerve network comes from the spinal cord and controls muscle movement and sensation in the shoulder, arm, and hand. Brachial plexus palsy occurs when this network of nerves is injured.
Brachial plexus injuries can happen during birth. The baby’s shoulders may become impacted on the mother’s pubic bone during the birth process, a condition known as shoulder dystocia. The brachial plexus nerves may be stretched or torn. Some injuries heal over time. Other injuries may require extensive therapy and maybe even surgery. Despite treatment, some injuries are permanent, resulting in lifelong disability and disfigurement.
Brachial Plexus Injuries Causing Erb’s Palsy
Erb’s palsy is paralysis of the arm caused by injury to the upper group of the nerves of the arm, the spinal roots between the fifth cervical vertebra and the seventh (C5–C7). It occurs in one or two out of every 1,000 infant births, usually from traumatic stretching of the brachial plexus during birth.
“Palsy” means paralysis or weakness. Erb’s palsy was named after renowned German neurologist Wilhelm Heinrich Erb, a pioneer in clinical neurology.
Infants with Erb’s palsy may suffer weakness, paralysis, and loss of feeling in the affected arm. In some cases, the child may be able to move the fingers, but not the shoulder. Most babies born with Erb’s palsy will need daily physical therapy to recover maximum function of the arm affected by the damaged nerves.
Children with Erb’s palsy are affected in different ways depending on the type of nerve damage. Symptoms can range from mild to severe. There are four different types of nerve injuries:
- Avulsion: The nerve is torn from the spine.
- Rupture: The nerve is torn but not where it attaches to the spine.
- Neuroma: The nerve has tried to heal but scar tissue has grown around the injury, placing pressure on the injured nerve and preventing signals from the nerve to the muscle.
- Neuropraxia: Nerve conducting is blocked at the location of the injury, often due to stretching, though the nerve fibers are intact.
What Are Common Symptoms of Erb’s Palsy?
Symptoms of Erb’s palsy may include:
- Lack of muscle control and no feeling in the arm or hand
- Minimal control of arm movements
- Use of hands but not of the shoulder or elbow
- Paralysis of the arm with the hand and fingers hanging limp
- Facial paralysis on the affected side
- Inability to sit without assistance
- Inability to crawl
Treatment for Erb’s palsy includes exercise and physical therapy to improve function. Some children who have suffered brachial plexus injuries resulting in Erb’s palsy require surgery.
Physical Therapy as Treatment for Erbs’ Palsy
Combating the Symptoms of Erb’s Palsy With Physical Therapy
Erb’s Palsy is a birth injury that is caused when the nerves in the baby’s neck and upper arm are damaged during childbirth. During birth, doctors sometimes attempt to deliver the baby by pulling or tugging on the baby’s head if the baby is moving too slowly through the birth canal or if the baby becomes stuck. Unfortunately, the nerves in the baby’s neck and upper arm are fragile and vulnerable to injury if they are stretched too far or torn. If these nerves – the brachial plexus nerves – are damaged, the child can sustain a serious and permanent injury to the affected arm, shoulder and/or hand. The child may have weakness, immobility, absent or decreased reflexes, and deformity of the arm or hand known as Erb’s Palsy or brachial plexus palsy.
Erb’s Palsy is relatively easy to diagnose, and most of the time, a child will begin to exhibit symptoms of the condition shortly after birth. Some of the most common signs of Erb’s Palsy include:
- Weak reflexes or lack of reflexes in the affected area
- Numbness or pain
- Inability to grasp objects
- Inwardly bent arms
- Difficulty moving the arms or shoulder
If a parent notices any of the symptoms listed above, he or she should immediately alert a physician or nurse.
The Role of Physical Therapy
When a child is affected by Erb’s Palsy, physicians will often recommend physical therapy. This is one of the most common methods of treating Erb’s Palsy, and a trained physical therapist will work to help a child develop strength and mobility in the afflicted arm. Prior to therapy, the therapist will work with the parents to develop and discuss the plan of action. The child’s physical therapy routine may include the activities below.
- Stretching exercises to increase range of motion;
- Resistance exercises and strengthening exercises;
- Sensory stimulation.
Another type of physical therapy, known as hydrotherapy, may be used during treatment of Erb’s Palsy. To prevent further pain, the child is placed into an anti-gravity environment (water), which allows them to perform therapy exercises on the affected area. Hydrotherapy has proven useful in treating a wide variety of injuries.
Legal Questions About Erb’s Palsy
If your child suffers from Erb’s Palsy and you have questions about whether the damage to the child’s nerves may have been caused by labor and delivery and may have been preventable, we welcome you to call Laura Brown, a Birth Injury Attorney at (214) 974-4121. Birth Injury Safety is a patient safety advocacy site to provide information about birth injuries and patient rights.
Brachial Plexus Injuries Causing Klumpke’s Palsy
Klumpke’s palsy is a type of brachial plexus palsy in which the lower nerves of the brachial plexus are injured causing paralysis of the muscles of the hand and forearm. In Klumpke’s palsy, the nerve roots at C8 (eighth cervical vertebrae) and T1 (first thoracic vertebrae) are injured.
When a child has suffered an injury related to prenatal care, labor or delivery, it is understandable for the parents to have questions about the injury, their legal rights and the legal rights of the child. We welcome the opportunity to talk with you about what has happened to your child and about your legal rights. Consultations are free – there is no obligation.
Facial Nerve Palsy: Facial paralysis due to facial nerve damage during delivery
What Causes Facial Paralysis?
The seventh cranial nerve, which controls the muscles of facial expression, is often called “the facial nerve.” It is vulnerable and can suffer damage during a complicated birth. If the mother is struggling to push the baby out, the obstetrician may decide to use forceps. If these tong-like devices are used incorrectly, it could put pressure on the infant’s face and damage nerves. This is most common in births involving large babies, long pregnancies, births involving epidural anesthesia, and births where medication was used to induce labor and stronger contractions.
Usually, only the lower part of the facial nerve is damaged during a difficult birth. This part of the nerve is responsible for the muscles around the lips. This health problem is noticeable and diagnosable when the infant cries.
A newborn affected by facial paralysis may have one eyelid that does not close; an uneven face while crying; a mouth that does not move the same on both sides; or complete paralysis on the affected side, from the forehead to the chin.
Correct Diagnosis Is Crucial
If any of these symptoms are seen, a physical exam should be done right away. Brain imaging tests and nerve conduction studies are often not required. A physical exam by a skilled medical professional is often all that is required to determine that the facial nerve was damaged.
Fortunately, this condition often improves with time. Many young victims of facial paralysis are able to recover within a matter of months. Facial paralysis can even go away on its own. Other infants, however, suffer from permanent paralysis and require special therapy.
Your doctor should be able to diagnose this condition while you are still at the hospital. Mild cases involving only the lower lip may take longer to notice. Look for uneven facial movements when your child cries and seek out medical attention right away if you notice anything that does not seem normal.
As is true with all birth injuries, some facial paralysis cases are the direct result of medical errors. When a medical professional acts negligently and causes harm to a child during labor or delivery, he or she can be held accountable for the victim’s suffering.
If your child has facial paralysis due to negligence, you may be able to pursue financial support.
Contact Laura Brown, Texas-based birth injury attorney
As any loving parent would, you want to be able to provide the best care for your injured newborn, but you may not have the financial means to do so. If your child’s injury was caused by negligence on the part of a medical practitioner during the prenatal stage, labor, or delivery, you should exercise your right to recover damages through a lawsuit.
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