Erbs Palsy

Causes

Erb palsy happens when a baby's neck is stretched during labor and delivery. This can result in damage to the upper nerves of the neck and shoulder. The nerve damage causes muscles in the baby’s arm to be weak.

Stretching may be caused by:

• A long, hard delivery
• A large baby was delivered
• Shoulder dystocia—when the baby's shoulder gets caught above the mother's pubic bone during delivery
• Breech delivery—a baby that is born bottom first instead of head first

Risk Factors

Things that may raise the risk of having a baby with Erb palsy are:

• History of delivering larger babies
• History of having a very long labor
• Gestational diabetes

Symptoms

A baby may have:

• Problems moving an arm or shoulder
• An arm that is bent in toward the body
• Poor reflexes in the arm

Diagnosis

Symptoms are often noticed after a baby is born. For others, the doctor may ask about the baby's symptoms and health history. A physical exam will be done.

Images may need to be taken. This can be done with:

• X-ray
• MRI scan

Muscle and nerve activity may need to be tested. This can be done with:

• Electromyography (EMG)
• Nerve conduction study

Treatment

Most babies get better with time, though some weakness may remain. Physical therapy can help with strength, flexibility, and range of motion.

Older kids who are not helped by other methods may need surgery to help with function. Choices are:

• Nerve graft or transfer
• Releasing thickened tissue around the joints
• Tendon transfer

Prevention

There are no known guidelines to prevent Erb palsy.