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Brachial Palsy



What is Brachial Plexus Palsy?

Brachial Plexus Palsy, or Erb's Palsy, is a condition in which the nerves connecting the spinal cord to the shoulder, arm, and wrist are damaged. The result is either impaired use or complete paralysis of the arm or hand. Symptoms of a brachial plexus injury include limpness and lack of muscle control in the arm or hand. Although the nerves of the brachial plexus can be injured at any time, most cases occur during the birth process. If the baby's shoulder is caught under the mother's pelvic bone, excessive stretching can injure or tear the brachial plexus nerves. The most common form of brachial plexus palsy is called neuropraxia, and it occurs when stretching has damaged the nerves but has not torn them. Many patients eventually recover from neuropraxia without treatment. The other three types of injuries are neuroma, rupture, and avulsion. Neuroma happens when damaged nerves try to heal themselves but form too much scar tissue in the process. The scar tissue then exerts pressure on the nerve, disabling its capacity to send signals to the muscles of the arm and hand. Rupture occurs when stretching causes the nerve to tear at any point except at the spinal attachment; if the nerve tears at there, the injury is called avulsion. While physical therapy and adequate time (usually several months) may help victims of neuropraxia and neuroma to recover, only surgery can improve cases of rupture or avulsion.

What causes it?

Brachial plexus injuries are usually caused by excessive stretching or tearing of the brachial plexus nerves. Again, most brachial plexus injuries occur during birth. Any position that results in too much pressure on the baby's head or neck, or anything that causes the muscles of the neck and shoulder to be strained can cause damage to the brachial plexus. Approximately, two to three infants out of every thousand suffer from a brachial plexus birth injury. Brachial plexus injuries can be caused by other events that traumatize the nerves connecting the spine to the arm. Car, motorcycle, and boat accidents, as well as sports injuries, can sometimes harm these nerves. A direct injury to the area, like a puncture wound from an animal bite, can also damage the nerves of the brachial plexus.

Is there any treatment?

While some brachial plexus injuries may heal without treatment, physical therapy is the most common form of intervention. The goal of the therapy is to increase the patient's ability to use the arm, as well as to prevent muscle atrophy or tightening. In some situations - especially with more severe injuries - surgery is needed in order to see improvement. Different, specific techniques can be used for adults and infants with brachial plexus palsy, but in either case, the goal is to restore as much movement as possible.

Are there any charity foundations for BP?

The National Brachial Plexus/Erb's Palsy Association, the Brachial Palsy Foundation, and the United Brachial Palsy Network are three national organizations that offer support and raise money for brachial palsy. Other organizations with information or services include the National Organization of Rare Disorders, the National Rehabilitation Information Center, and the National Information Center for Children and Youth with Disabilities.