Brachial palsy in newborns

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Brachial palsy in newborns

Definition

Brachial palsy is a loss of movement or weakness of the arm caused by damage to the collection of nerves around the shoulder. This bundle of nerves is called the brachial plexus.

Alternative Names

Klumpke paralysis; Erb-Duchenne paralysis; Erb's palsy

Causes

Brachial nerve injuries can occur 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 excessive pulling on the shoulders during a head first delivery or by pressure on the raised arms during a breech (feet first) delivery.

There are different forms of brachial palsy in an infant. The type depends on the degree of arm paralysis:

Brachial plexus injuries typically affect only the upper arm.
Erb's paralysis affects the upper arm and rotation of the lower arm.
Klumpke paralysis affects the hand. Tthe infant may also have an eyelid droop on the opposite side.

The following increase the risk of brachial palsy:

Breech delivery
Larger than average newborn
Shoulder dystocia

Brachial palsy is less common now that delivery techniques have improved and cesarean delivery is more often used when needed.

Review Date: 10/11/2007
Reviewed By: Deirdre O’Reilly, MD, MPH, Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts. Review Provided by VeriMed Healthcare Network.

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