Living With Erbs Palsy Plus Explanations Concerning The Condition And Treatment

Normally caused during birth, Erb-Duchenne palsy affects the main group of nerves located in the top part of the arm. The damage that has been caused will have a lot to do with the treatment that will be necessary to correct the problem. Living with Erbs Palsy may result in paralysis and may last for only a few short months, but in other cases extended therapy or surgery may be required.

This type of palsy is often caused during childbirth when shoulder dystocia occurs. Shoulder dystocia is the condition whereby the baby’s head presents but the shoulders are unable to pass through the pelvic bone without some form of manipulation. This is almost always an emergency situation because the umbilical cord is being compressed; time is limited to five minutes due to the possibility of a fatality.

This condition can also result due to a serious fall during adulthood. Nerves can become severely stretched when a person falls to one specific side injuring the shoulder, head and neck. Correcting a dislocated shoulder and a gunshot wound may also have the same consequences.

Partial or complete paralysis are very real possibilities. Three particular nerves are the most affected and these include the musculocutaneous nerve, the axillary nerve and the suprascapular nerve. Bruising or tearing of these nerves can cause the damage.

The area affected is known as the Erbs Point which is named for Wilhelm Heinrich Erb a German neurologist. There are six nerves that join together at this point. Its location is just above the collar bone and includes all of the nerve fibers that run from the spine through the neck, then through the armpit and arm.

Signs associated with the palsy can range from lack of sensation to paralysis of the arm because of weakened muscles that are involved. The muscles that become most affected by this condition are the brachialis, the deltoid, and the biceps. Generally the arm is unable to be raised and must be left in a position of hanging at the side with the hand facing toward the front. Waiters tip is a common name for this position.

Nerve and latissimus dorsi tendon transfers along with subscapularis release are three common forms of treatment. Nerve transfers use nerves taken from the opposing leg and are reserved for babies under the age of nine months due to the possibility of further nerve damage. Limitations do not apply currently to the other two procedures.

External rotation is improved by tendon transfer however, due to muscle position following surgery; increased sensitivity is a very common occurrence. Range of motion can be greatly increased with subscapularis releases and this procedure can be done more than once if necessary. There is the possibility of weakening the existing muscle with the surgery being repeated.

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