Erb’s Palsy or Brachial Plexus Birth Palsy is a disorder causing weakening & loss of movement of arm. Erb’s palsy is a neural defect that affects the nerves around the neck. Brachial plexus is the structure of nerves surrounding the neck which develop into the arm nerves. Movement of the upper limbs is controlled by these nerves. Erb’s palsy is characterized by progressive weakening of muscles & loss of movement in the arms.
Symptoms of Pediatric Brachial Plexus Birth Palsy
Commonly seen symptoms of Pediatric Erb’s Palsy include –
- Weakness & loss of movement in the arms
- Rotating lower arm becomes difficult
- Rare cases show minor paralysis which makes affected side’s eyelid to droop
Pediatric Brachial Plexus Birth Palsy Causes
Erb’s palsy is the direct result of an injury to the nerves surrounding the neck region. Most cases of pediatric Erb’s palsy are caused by undue stretching of the nerves around the baby’s neck at the time of birth. Erb’s palsy severity is decided by the type of injury to the brachial plexus nerves.
These are –
- Neurapraxia – When the nerves are not torn but unduly stretched, it is known as Neurapraxia. It is identified by a stinging sensation around the injured part. This type occurs in children as well as adults.
- Neuroma – This is slightly more severe than Neurapraxia. In this damage to the nerves result in scar tissue. The damaged nerve puts undue amount of pressure on the surrounding nerves & affects their functioning.
- Rupture – It occurs when the nerve tissue is damaged or torn completely. This type of palsy requires immediate medical attention.
- Avulsion – This is the severest form of Erb’s palsy. In this the nerve is completely disconnected from the spinal cord which leaves the nerves as useless.
Types of Brachial Plexus Birth Palsy
Erb’s palsy is mainly divided into two types depending on the extent of loss of movement.
These are –
- Brachial Plexus Birth Palsy – In this form of Erb’s palsy damage is limited to the upper nerves. It means the child can move his shoulders but the movement of fingers is restricted.
- Total Brachial Plexus Birth Palsy – This type is identified when the upper & lower nerves in the arms are affected. Loss of movement is seen along the arm from shoulder to the fingertips.
Brachial Plexus Birth Palsy Treatments
Treatment of Erb’s palsy is totally dependent on severity of nerve damage. These are some of the options suggested by doctors as treatment for Erb’s palsy –
- Hydrotherapy – Hydrotherapy is a form of physical therapy which is done under water. The weightlessness of the body under water eases stress off the musculoskeletal structure of the child. This allows easier movement in the affected limb & which helps regain strength & movement. Hydrotherapy also helps in decreasing involuntary muscle spasms. It is helpful in relieving pain & stress from the affected limb.
- Physical Therapy – Physical therapy is often required so as to enhance normal movement of the affected limb. It also helps regain strength & muscle mass in the limb.
Physical Therapy often includes –
- Light stretching exercises
- Stimulation of sensory nerves
- Motion exercises for recovering normal movement
- Strength exercises to help build muscle mass
- Occupational Therapy – Occupational therapy is normally recommended after surgery. It is useful in helping the child perform daily activities such as eating, playing, using fine motor skills, etc. Depending on the severity of individual cases the physiotherapist may suggest special exercises for children.
- Surgery – Surgery is suggested by doctors for more severe types of Erb’s palsy cases where physical therapy is not sufficient.
Surgery is of two types –
Nerve Graft Repairs – Nerve graft procedure includes replacing damaged nerves with healthy sensory nerves taken from another part of the body. In a short period of time the grafted nerves reconnect with the original nerves & start functioning normally.
Nerve Decompression – Nerve decompression is a minor surgical procedure. It involves making a minor incision in the skin through which a specialized surgical instrument is inserted & which decompresses the affected nerves. Decompression of the affected nerves relieves stress on these nerves which allows them to recover naturally.
Brachial Plexus Birth Palsy Treatment & Surgery in India
Erb’s palsy is a birth disorder that requires urgent medical treatment & surgery. Along with surgery the cost of necessary physical therapy can sum up to be quite expensive. India has a vast plethora of experienced doctors & well-trained surgeons who are accomplished in handling brachial plexus birth palsy cases. Coupled with the huge network of hospitals & healthcare centers across all major cities, India is one of the most prominent choices for Erb’s palsy treatment & surgery for people from all around the world. Affordability & good connectivity for traveling to cities like Mumbai, Chennai, Bangalore, Goa & Delhi make India an extremely convenient option for international travelers.