Erb's Palsy

Erb’s Palsy, also known as Brachial Plexus Paralysis, is a condition commonly caused during childbirth when an infant sustains injuries associated with dystocia (abnormal or difficult labor or birth.) It can occur if the infant’s head and neck are pulled toward the side simultaneously as the shoulders pass through the birth canal, resulting in damage to the Brachial Plexus, a network of nerves that run from the spine to the fingertips, with one or all of the five primary nerves that control sensation and movement in an arm involved.

During a vertex (head first) delivery, excessive pulling on the shoulders can cause Erb’s Palsy. It can also occur during a breech (feet first) delivery by pressure on the raised arms. Applying unnecessary and excessive force during a delivery can traumatize the infant and lead to Erb’s Palsy.

Paralysis to the arm can vary in severity, as can nerve damage, ranging from bruising to, infrequently, tearing. In extreme cases, the injury can leave patients with stunted growth in the affected arm, and with impaired muscular, nervous and circulatory development.

Usually the paralysis is temporary, lasting only a day or two; in some cases, however, the paralysis represents tearing of the nerves and can last much longer. In these cases physical therapy may be needed, and in the most severe cases, surgery may be necessary.

Negligence on the physician’s part may contribute to the risk of Erb’s Palsy, including failure to estimate a baby’s weight before delivery, or to prepare adequately for the birth of a large infant. Failure to diagnose and treat maternal diabetes can play a role. Also, failure to perform appropriate delivery techniques during shoulder dystocia and, at worst, failure to perform a caesarean section when indicated can lead to Erb’s Palsy.