Erb's
Palsy also known as Brachial Plexus Paralysis
is a condition which mainly due to birth trauma, can affect
1 or all of the 5 primary nerves that supply the movement
and feeling to an arm. Each baby's injury is individual.
The paralysis can be partial or complete; the damage to
each nerve can range from bruising to tearing. Some babies
recover on their own however some may require specialist
intervention. Early
Intervention is crucial in order to ascertain
the full extent of damage caused. There are tests, which
can be carried out that show which nerve/s are damaged.
Treatment in the first year of life can have a significant
impact on recovery. However, if there is no progress or
you are worried, you might want to ask your doctor or paediatrician
to refer your child to a specialist within the field of
Erb's Palsy. Treatment
Available: PHYSIOTHERAPY
- OCCUPATIONAL THERAPY - HYDROTHERAPY - NERVE GRAFTS
- TENDON/MUSCLE RELEASE What is the
Brachial Plexus?  The
brachial plexus is made up from five large nerves which
come out of the spinal cord between the bones in the neck
(the vertebrae) and give movement and feeling to the arm
These nerves are represented by the symbols C5, C6, C7,
C8 and T1Shortly after coming out of the neck, the nerves
come together and then divide among the muscles and tissues
of the arm. The brachial plexus runs from the neck and
passes under the collarbone to become the major nerves
of the arm at about the level of the armpit.
What are
nerves? Nerves are cord
like structures of tissue from a collection of nerve fibres.
A single nerve may contain thousands of fibres, a bit like
a telephone cable. In the arm, these fibres carry electrical
messages both ways between the brain, muscles and tissues.
For a muscle to work (contract) a message must travel from
the brain along a nerve that goes directly to the muscle.
When nerve fibres are injured, the muscles that the nerve
controls may be weakened, even though the injury is not in
the muscle itself.Nerves outside the spinal cord (peripheral
nerves) can repair themselves. Damaged nerve fibres are able
to regrow at a rate of about 1mm a day or 1 inch a month.
It may take many months for regrowing fibres to reach the
muscles in the lower arm. If an entire nerve has been damaged
or broken, it will not grow back to the muscle. What happens
when there is an injury to the Brachial Plexus? Many factors affect
how severe the injury is. The first is the number of nerves
that have been affected. Of the five nerves of the brachial
plexus the first two, (C5 C6) are most often involved. A
classic sign of this is an elbow which does not bend and
the hand being held in a 'waiters tip' (turning backwards)
position.Sometimes all the nerves may be affected, if this
occurs, weakness or paralysis will affect the entire arm
and hand. Signs of this may also include a limp hand and
there may be an associated Horners syndrome. This is when
the eyelid droops and the pupil in the eye may be smaller.
The baby may also have an associated Torticollis. Torticollis
is where the baby faces away from their affected arm and
is unable to face forward for any length of time. Your baby
may also suffer from sensory loss in the arm and hand. The second is how
badly the nerve has been damaged. If the fibres have
only been mildly stretched, your child should recover use
of the muscle quite quickly. The more fibres that are
stretched or pulled apart, the weaker the muscle will be
and the longer it will take to start working properly again.
A nerve that has been severely damaged but still remains
connected may heal, but scar tissue may form at the site
of injury. This scar tissue may stop the electrical messages
so they can't work getting to the muscles. A nerve that is
completely pulled apart cannot repair itself, so the muscles
it controls are paralysed. Sometimes it is possible to have
an operation to mend the nerve and restore some function
to the muscle, if this is necessary, the child is likely
to be left with some residual weakness in the arm. In rare
cases the nerve may be torn away from the spinal column itself – this
is called an AVULSION in these cases it is imperative
to consult a specialist in Brachial Plexus Injuries as soon
as possible to discuss a treatment plan. | 