Information about this rare condition.

Erb's Palsy

ERB'S PALSY
* A palsy is a term used to describe certain types of paralysis. With any type of paralysis, there is loss of movement of part of the body, caused by the inability to contract single muscles or groups of muscles. Sometimes there may not be total loss of power, but more a weakness of the affected muscles this is reffered to as paresis rather than paralysis.

* Types of palsy include cerebral palsy, Bell's palsy and Erb's palsy. Cerebral palsy usually results from damage before or during birth and causes stiffness and contracture of muscle groups, loss of balance and writhing movements of the limbs. Bell's palsy is paralysis of the facial muscles often due to damage or inflammation of the facial nerve.

* Erb's palsy which is, thankfully, a rare condition usually results from traction to the neck of the baby during a difficult childbirth, when the doctor has to pull on the baby's arm to help the baby through the birth canal. The force needed to `get the baby out' may cause severe stretching or tearing of the nerves that supply the arm and hand.

* These nerves, come out between the vertebrae of the neck from the spinal column, passing deeply beneath the collar bone and through the armpit on their journey to the arm and hand. They not only control movement of muscles in the upper arm, forearm and hand but they also carry the messages of sensation (such as touch, pain pressure etc) felt in the arm.

* Apart from injury at birth these important nerves can also be damaged by penetrating wounds to the neck or armpit, fracture of the collar bone, or dislocation of the shoulder. Pressure on these nerves may also produce Erb's paralysis, as can occur as a result of tumours, enlarged glands or an aneurysm (a pulsating enlargement of an artery).

* Other causes of damage to these nerves are direct injury that may occur during surgery to the region, or indirect damage that can occur as a result of traction and pressure during operations in this area. Industrial accidents and especially road traffic accidents are becoming more common causes of injury to these nerves.

* The muscles affected by Erb's paralysis are the biceps, deltoid and other muscle groups that surround the shoulder joint and upper back. The result of such muscle involvement produces a paralysis that causes inability to lift the affected arm sideways or forewards. The arm cannot be flexed at the elbow and so remains permanently straight, however, movements of the wrist and fingers are not impaired. Sensation is lost or impaired along the outer edge of the whole arm, right down to the wrist, thumb and index finger.

* As a result of such paralysis, the arm and hand are held in what has become known as the `waiter's tip' position, with the arm straight and the hand curled upwards and outwards

* Not a great deal can be done for Erb's paralysis, though some specialist units are using surgery to the affected nerves or muscles or joints to produce some form of useful if not complete limb movement.


IMPORTANT NOTICE : This content is from the Dr Chris Steele personal archive and is provided for convenience only. Information contained here may no longer agree with the most up to date medical advice. Please check with a medical professional before taking any action.

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