Erb's Palsy is one of the most common and serious brachial plexus injuries. The brachial plexus is the network of nerves that run from the spine to the shoulder and fingertips. Most Erb's Palsy injuries occur during childbirth, when the baby's shoulder is caught behind the mother's cervix (called "shoulder dystocia"). If the obstetrician uses excessive force to release the baby's shoulder, the baby's brachial plexus may be injured, resulting in Erb's Palsy. This injury may result in partial or complete paralysis of the baby's arm and could be permanent.

The risk of having a baby with Erb's Palsy increases with the following factors:

1. High birth weight (over 8 lbs 14 oz)
2. Heavier mothers
3. Maternal diabetes
4. Short stature of mother
5. Contracted or flat pelvis
6. Pregnancy longer than 40 weeks

There are four different kinds of nerve injuries associated with Erb's Palsy, including:

• Stretch injuries - the mildest form of nerve injury; infants usually recover within 1-2 years and regain complete function. Nerves are compressed from swelling and bruising from the shoulder being caught.


• Neuroma injuries - occurs when scar tissue puts pressure on the injured nerves; surgery may be required for treatment. Improvement usually seen within 3 months.


• Rupture injuries - the nerve is torn in several places. Surgery and therapy are required to restore normal function.


• Avulsion - the most serious brachial plexus injury, occurs when the nerve is torn from the spinal cord. Extensive surgery is required to restore function.

Erb's Palsy symptoms will vary depending on each child. Some examples of Erb's Palsy symptoms include: a paralyzed arm with hand hanging limp, loss of use of shoulder or elbow, no muscle control, no feeling in the arm or hand, or facial paralysis on the affected side.

About 80 percent of babies with Erb's Palsy do recover within the first three months. However, this leaves 20 percent who still suffer from residual paralysis. In these cases, surgery may be effective in treating children with brachial plexus injuries. However, the surgery must be performed when the child is 5 to 12 months of age; beyond that the surgery will not be as effective. The surgical procedure is done by a pediatric neurosurgeon and two or more procedures may need to be performed. Other than surgery, exercise and physical therapy may also help children with Erb's Palsy to improve muscle and joint function.

A birth injury like Erb's Palsy is very difficult for the child as well as for the entire family. If your child suffers from a brachial plexus injury like Erb's Palsy and you wish to bring legal action, you need an experienced birth injury attorney to advise you of your legal options. For more than 35 years, the firm of Oshman & Mirisola, LLP has successfully represented clients in Erb's palsy, cerebral palsy and other birth injury lawsuits. Contact us by calling (800) 400-8182 and ask for Partner Ted Oshman, or fill out and submit our online Contact us form for a free initial consultation.