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Brachial Plexus Birth Injuries

By Burg Simpson
January 13, 2020
4 min read

Including Erb’s Palsy, Klumpke’s Palsy, and Global Palsy

While childbirth is safer than ever, birth injuries can still occur. This article discusses one such injury: brachial plexus injury. According to studies, brachial plexus injuries occur in 2-5 out of 1,000 births.

What is the brachial plexus?

As you know, the brain controls the rest of the body by sending electrical signals down through the spinal cord, out through nerve roots, and on to the nerves throughout your body. The brachial plexus is the system of nerves that begin in the neck, at four cervical nerve roots (C5-C8) and one thoracic nerve root (T1), and extend down into the arm. These nerves control the movement and feeling of the shoulder, arm, and hand. Injury to these nerves, therefore, can result in loss of movement and sensation in the shoulder, arm, or hand.

What are the types of brachial plexus birth injuries?

Brachial plexus injuries are categorized both by how badly the nerves are damaged and by which nerves were damaged.

Types of damage to the nerve:

  • Avulsion: the nerve is completely torn from the spinal cord
  • Rupture: the nerve is torn but not at the spinal cord
  • Neuropraxia: the nerve is stretched
  • Neuroma: a stretched nerve that has developed scar tissue, which disrupts signals to the muscles

Brachial plexus conditions:

  • Erb’s Palsy:
    • This is the most common of the brachial plexus injuries.
    • It involves the C5 nerve, but can also involve nerves C6 and C7.
    • Those with Erb’s Palsy generally have weakness in and difficulty moving the shoulder and arm, but have intact hand function.
  • Klumpke’s Palsy:
    • It involves injury to C8-T1.
    • Those with Klumpke’s Palsy generally have weakness and loss of movement in the arm and hand, but have intact shoulder function.
  • Global Palsy:
    • Global Palsy involves all of the nerves in the brachial plexus.
    • Those with Global Palsy generally are unable to move the shoulder, arm, or hand.

How can the brachial plexus be injured at birth?

A brachial plexus injury can occur during a complicated delivery. Most commonly, it occurs in the setting of shoulder dystocia. Shoulder dystocia occurs when the baby’s shoulder becomes lodged on the mother’s pelvis during delivery. When this occurs, the obstetrician will perform certain maneuvers to dislodge the baby; however, in the process, excessive force can be applied to the baby’s neck, causing tearing and/or stretching of the brachial plexus nerves.

What are the treatments for a brachial plexus injury?

The treatments available depend on the severity of the brachial plexus injury. For example, those with mild neuropraxia may only require occupational and physical therapy. For more serious injuries, such as an avulsion, surgery may be necessary. Regardless of severity, it is important for children with obstetrical brachial plexus injuries to receive early evaluation and treatment, preferably by a brachial plexus specialist.

What is the outlook for brachial plexus injuries?

The outlook largely depends on the severity of the injury, the treatment received, and the timing of the treatment. For example, most children with mild neuropraxia can have full resolution with treatment. A child who suffered an avulsion, however, is more likely to have some degree of permanent impairment even with treatment.

The timing of treatment is also critical. Muscles that are not connected to a nerve will eventually begin to atrophy or waste away. After some time, the muscles will become so atrophied that they cannot be reconnected to the nerve.

My baby has a brachial plexus injury. Do I need to speak with an attorney?

Not every bad outcome is due to malpractice; however, a brachial plexus injury may be the result of improperly treated shoulder dystocia. An experienced birth injury attorney will be able to evaluate your potential case and, if your baby’s injuries are due to a medical provider’s negligence, help your family get compensation for the injuries your child has suffered.

If your child has been seriously injured during the delivery process, call a Cincinnati birth injury lawyer today. Our dynamic team of medical malpractice lawyers have helped those injured in Ohio, Kentucky, and across the nation. They can help you too! Call the attorneys in Burg Simpson’s Cincinnati, Ohio office at 513-852-5600 or fill out our free case evaluation form now to discuss your case with us.

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