INFORMATION ON ERB-DUCHENNE AND DEJERINE-KLUMPKE PALSIES

Brachial palsy is a paralysis or weakness of the arm caused by injure to the brachial plexus (the collection of nerves around the shoulder).

CAUSES OF ERB-DUCHENNE AND DEJERINE-KLUMPKE PALSIES

Brachial nerve injuries can take place during a difficult delivery. For example, it can occur if the infant's head and neck are pulled toward the side as the shoulders pass through the birth canal.
The condition can also be caused by extreme pulling on the shoulders during a vertex delivery (head first) or by pressure on the raised arms during a breech delivery (feet first).

The newborn may have varying degrees of arm paralysis:
• Brachial plexus injuries usually affect only the upper arm
• Erb's paralysis affects the upper arm and rotary motion of the lower arm
• Klumpke paralysis affects the hand (the newborn may also have an eyelid droop on the opposite side)

Brachial palsy is less common now that delivery techniques have improved and there is more use of C-sections when needed (where the baby is removed surgically through the abdomen).
Risk factors include a larger than standard newborn, shoulder dystocia, and breech delivery.
Arm and shoulder fractures can also affect newborns who have had a complicated delivery. Fractures can cause pseudoparalysis. The symptoms may be very similar, although the long-term outlook is very different.

SYMPTOMS OF ERB-DUCHENNE AND DEJERINE-KLUMPKE PALSIES

Brachial palsy injury can include a limp or paralyzed limb; lack of muscle organize in the arm, hand, or wrist, and lack of feeling or sensation in the arm or hand.

TREATMENT OF ERB-DUCHENNE AND DEJERINE-KLUMPKE PALSIES

A full recovery is expected in most cases. Hardly ever, the palsy may continue. If some force has not returned to the affected muscles by 3-6 months of age, surgery on the nerves may restore it. Tendon transfers may also help to compensate for nerves that are not functioning properly.
Gentle massage of the arm and range of motion exercises are recommended for mild cases. In more harsh cases, a pediatric neurologist and an orthopedic hand surgeon may need to be consulted.
In cases of pseudoparalysis, the child will begin to use the affected arm as the fracture heals.