Erb's Palsy/ Brachial Plexus

Erb’s Palsy, also referred to as Brachial Plexus Birth Palsy, is an often preventable nerve injury that can occur during the birthing process. After the head has been delivered the newborn’s shoulder can get caught on the mother’s pelvic bone, a condition called Shoulder Dystocia. If the medical provider applies excessive pressure to the baby’s head when shoulder dystocia is encountered, damage can be caused to the bundle of nerves called the Brachial Plexus.
Injury to these nerves can affect the upper portion of the arm and can cause loss of movement to the baby’s hand muscles and shoulders.

While some brachial plexus injuries heal without treatment, many require extensive treatment or surgery and some children may sustain life-long problems depending on the nature and the extent of the damage.

Potential Risk Factors for Shoulder Dystocia:

  • Prolonged labor

  • The mother is a diabetic, gestational or otherwise

  • The mother is short or small and may have a small pelvis

  • The mother is of advanced maternal age

  • The mother is obese

  • Above-normal weight gain during pregnancy

  • Macrosomia – newborn with anticipated excessive birth weight

  • Pregnancy extending beyond 40 weeks

  • Instance of shoulder dystocia in previous deliveries

If shoulder dystocia is encountered during a delivery, there are several things a medical provider can do to dislodge the impacted shoulder such as performing a McRobert’s Maneuver or a Wood’s Corkscrew maneuver, making an episiotomy, applying suprapubic pressure, or attempting to deliver the posterior arm.

Brachial Plexus Symptoms

The brachial plexus nerves can be bruised, stretched or torn and symptoms can vary widely including:

  • Paralysis of the baby’s arm and hand
  • Partial or full loss of hand use or other extremities such as the elbow or shoulder
  • Stunted growth in the effected arm often continuing from the shoulder to the finger tips. (Thus one arm being smaller and weaker than the other).
  • Limp arm with a bent wrist and a turned forearm
  • Limp hand with immovable fingers Some movement in the arm, but limited control over the wrist and hand
  • Use of the hand with limited use of the shoulder or elbow
  • No muscle control over the affected area
  • Impaired movement in the hand with immovable fingers
  • Facial paralysis on the damaged side
  • Eyelid droop
  • Weakness or loss of feeling in the arm
  • A rotated and deformed wrist and arm
  • Arm flexed (bent) at elbow and held against body
  • Lack of muscle control over the affected area
  • Phrenic nerve damage (causing paralysis of the diaphragm)
  • Numbness of the arm
  • Brachial plexus injuries can affect the upper arm and lower arm. Another type of palsy, Klumpke’s Palsy, can also affect the hand.

Diagnosis and Treatments

Preliminary diagnosis may be based on the doctor or family noticing the symptoms listed above. Further tests may include an electromyogram (EMG) or a nerve conduction study (NCS).

The most common treatment methods are:

  • Physiotherapy
  • Occupational Therapy
  • Surgery
  • Hydro Therapy

The severity of the palsy injury will often dictate the available treatment options and the likelihood that the child’s injury will be permanent. It is important for parents to be actively involved in the treatment process so that the child can recover maximum function in the affected arm.

If your child has suffered from an injury which occurred during the birthing process, we want to hear your story. Our experienced birth injury attorneys will review the facts and assist you with your case from beginning to end. We know how to investigate and aggressively pursue medical malpractice claims and we will fight for your rights.


Contact the Law Offices of Stephen S. Weinstein, P.C.
for your free personal consultation today.

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