Erb’s Palsy – What Is It, How Is It Caused

Erb’s Palsy is a nerve injury that effects the movement of a child’s shoulder, arm, and hand. 
Erbs palsy usually happens when too much force is applied to the baby’s head, while trying to pull out a baby stuck in the birth canal.  The baby may be too large to fit easily through the birth canal. 
When the baby’s shoulder gets stuck in the birth canal, it is called shoulder dystocia.  Pulling on the baby’s head stretches and injures the nerves in the stuck shoulder. The injured nerves are between the shoulder and the neck.  These nerves provide movement to the arm, hand, and fingers.  This collection of nerve fibers is called the brachial plexus or Erb’s Point. Most of the time these nerves are only somewhat injured and the baby may regain movement in a few months.  About 20 percent of the time, the injury is so severe, or the nerves are torn from their points of attachment to the spine or they may be ruptured, so that paralysis of the arm and shoulder is permanent.  This injury may result in varying degrees of weakness or paralysis of the shoulder, arm, or hand.  Which part of the arm is involved, depends on which nerves are injured.  A baby with this injury holds his limp arm down by his side with forearm turned inward and wrist bent.  The baby cannot lift the arm up.   A baby with a very bad injury may also have a droopy eyelid on the side that was injured. There are tests that can diagnosis brachial plexus injury. Your baby’s physician may order an x-ray of the neck, an MRI, and maybe even nerve conduction tests. A pediatric neurologist may be asked to evaluate the degree of injury and therapists might be called in to design slings or splints, to perform and teach the parents to do exercises to keep the arm limber, and to be part of a rehabilitation process.  Sometimes surgeries have been helpful to restore some function.