Erb's Palsy: Brachial Plexus Paralysis

Erb's Palsy is mainly caused by birth trauma when traction of the head or arm, or twisting the arm or shoulder down and backward, results in paralysis of the nerves supplying the arm. There are three main types of paralysis:

• Erb's Palsy is a paralysis of the shoulder and elbow, involving the 5th and 6th cervical nerves. This manifests itself with the arm being turned towards the body, the elbow unable to bend and the hand being in the 'waiters tip' position.
• Klumpke's Paralysis involves the 7th and 8th cervical and 1st thoracic nerves. The result is a flaccid paralysis of the hand which is often associated with Horner syndrome - drooping of the eyelid, the cheek does not sweat and the pupil may be smaller than the unaffected side.
• Complete paralysis of the arm occurs when all the above five nerves are affected. The entire arm is paralysed and there is demonstrable sensory loss. Horner syndrome is often present as is Torticollis.

The incidence of Erb's Palsy is now established at 1 in 2,000 live births. It is now possible to say that over half of children born with Erb's Palsy make a complete recovery and another thirty to thirty-five per cent make very useful recovery as relates to nerve injuries, but that between twenty-five to thirty per cent of the children face difficulties due to contracture at the shoulder leading to posterior dislocation of that joint. Properly conducted neurophysiological investigations are most helpful in determining the likelihood of recovery. The indication for an urgent operation can be restricted to a relatively small number of children who have complete and severe injuries or those who have suffered major injury to the plexus from breech delivery.

Inheritance patterns
None

Prenatal diagnosis
None

Medical text written November 1992 by Dr R Birch. Last updated January 2004 by Professor R Birch, Consultant Orthopaedic Surgeon, Royal National Orthopaedic Hospital, Stanmore, UK.

Further Online Resources
Medical texts in The Contact a Family Directory are designed to give a short, clear description of specific conditions and rare disorders. More extensive information on this condition can be found on a range of reliable, validated web sites and links to them are included in the CD-ROM version of this Directory. Further information on these resources can be found in our Medical Information on the Internet article.

ERB'S PALSY GROUP

Erb's Palsy Group
60 Anchorway Road
Coventry CV3 6JJ
Tel: 024 7641 3293
e-mail: info@erbspalsygroup.com
Web: http://www.erbspalsygroup.co.uk

The Group is a National Registered Charity No. 1036423, established in 1992. It offers support to parents and professional workers and contact between parents where possible. It gives advice on benefits and aids for affected children and aims to raise public & professional awareness of the condition. It publishes a quarterly newsletter and has information available, details on request. The families of over 1,000 children and 125 professional workers are in membership.

Group details last updated August 2007.