Presentation
In the current paper, case of Erb’s palsy in an adult is presented and the anatomical bases of the clinical presentations are discussed. [medcraveonline.com]
Risk factors Risk factors in Erbs palsy Fetal factors Maternal factors Factors related to labour Macrosomia Maternal propulsive forces Lateral traction exerted on head and neck during delivery in vertex presentation Arm extended overhead in breach presentation [patient.info]
At delivery, which was videotaped by the father, the fetal head presented over an intact perineum in a right-occiput-anterior position. [ncbi.nlm.nih.gov]
One or two in every 1,000 babies present with this condition. It is often caused when an infant’s neck is stretched to the side during a difficult delivery. [colemanlegalpartners.ie]
Entire Body System
- Weakness
weakness and paralysis of the arm Erb's palsy is The brachial plexus Brachial plexus injury affects.. [quizlet.com]
[…] will perform a physical examination to evaluate arm weakness. [baptisthealth.com]
Palsy means weakness, so therefore brachial plexus birth palsy causes arm weakness and loss of motion in newborn babies. What is Erb’s Palsy / Erb–Duchenne palsy? Erb’s palsy (or Erb–Duchenne palsy) is a form of brachial plexus palsy. [colemanlegalpartners.ie]
All of these types of Erb’s Palsy can result in weakness or paralysis. [golombhonik.com]
Neurologic
- Paresis
Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohsen Basiri M.D. ,Mohamadmostafa Jahansouz M.D.[2] Niloofarsadaat Eshaghhosseiny, MD[3] Synonyms and keywords: Idiopathic facial paralysis,Idiopathic facial nerve paresis,Facial nerve disorder [wikidoc.org]
[…] corresponding parts on both sides of the body disfunction, dysfunction - (medicine) any disturbance in the functioning of an organ or body part or a disturbance in the functioning of a social group; "erectile dysfunction"; "sexual relationship dysfunction" paresis [thefreedictionary.com]
- Flaccid Paralysis
[…] diseases characterized by episodic flaccid paralysis or muscular weakness. progressive bulbar paralysis the chronic form of bulbar paralysis; called also Duchenne's disease or paralysis. [medical-dictionary.thefreedictionary.com]
Lower plexus and total plexus injuries (often signified by flaccid paralysis of an entire arm, or diaphragmatic injury, or Horner’s syndrome) have worse prognoses. [pedclerk.bsd.uchicago.edu]
- Paresthesia
Symptoms of this type of injury are known as “stingers” or “burners” since they cause unilateral burning in the affected arm, as well as weakness, paresthesia, and the inability to flex or abduct the arm. [pedclerk.bsd.uchicago.edu]
Workup
Order a neurologic evaluation to recommend further workup and to establish baseline loss of function so that improvement may be monitored. [pedclerk.bsd.uchicago.edu]
Utility of ultrasound in noninvasive preoperative workup of neonatal brachial plexus palsy. Pediatr Radiol. 2015 Dec 30. [Medline]. van der Holst M, Groot J, Steenbeek D, Pondaag W, Nelissen RG, Vliet Vlieland TP. [emedicine.medscape.com]
Workup may include urinalysis, electrolytes, BUN, creatinine, PSA, and bladder ultrasound. [frontiersin.org]
Treatment
Afdelingslæge Michael Davidsen, professor Ivan Hvid & overlæge Bjarne Møller-Madsen Århus Universitetshospital, Århus Sygehus, Ortopædkirurgisk Afdeling E, Børneortopædisk Sektion Reference: Ugeskr Læger 2005;167(11): 1259-1263 Summary: Summary Primary treatment [ugeskriftet.dk]
Treatment Some brachial plexus injuries may heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment for brachial plexus injuries includes physical therapy and, in some cases, surgery. [childneurologyfoundation.org]
There are both non-surgical and surgical treatment options for Erbs and Brachial Plexus palsy. [colemanlegalpartners.ie]
Surgical Treatment The three most common surgical treatments for Erb’s Palsy are Nerve transplants Subscapularis releases Latissimus Dorsi tendon transfers. [boneandspine.com]
Prognosis
Prognosis The site and type of brachial plexus injury determines the prognosis. For avulsion and rupture injuries, there is no potential for recovery unless surgical reconnection is made in a timely manner. [childneurologyfoundation.org]
Prognosis The prognosis for Erb’s palsy depends on where the injury took place and how much severe it is. [doctoralerts.com]
The prognosis is better for lesions in the neonate than the adult. Links: aetiology diagram of Erb-Duchenne palsy brachial plexus lesions [gpnotebook.com]
Effective hand grasp throughout is associated with a good prognosis. Function may return within a few months. Some may have been left with permanent damage. [patient.info]
Most individuals with neuropraxia injuries recover spontaneously with a 90-100 percent return of function. x Prognosis The site and type of brachial plexus injury determines the prognosis. [ninds.nih.gov]
Etiology
The etiology of Brachial Plexus Injury is multifactorial. [pedclerk.bsd.uchicago.edu]
Obstetric paralysis: Its etiology, pathology, clinical aspects and treatment, with a report of four hundred and seventy cases. Am J Dis Child. 1916. 12:541-78. Gilbert A, Tassin JL. Obstetrical palsy: a clinical, pathologic, and surgical review. [emedicine.medscape.com]
We report a Vietnamese family including a 10-year-old child diagnosed with cerebral palsy without etiologic diagnosis and a fetus with central nervous system malformations. [bmcmedgenet.biomedcentral.com]
Epidemiology
Epidemiology It is rare. In the USA the incidence has been quoted as 1.6-2.9 per 1,000 live births. [ 1 ] Upper plexus palsies are more common than lower plexus palsies. 50% of cases are associated with shoulder dystocia. [patient.info]
Bell's palsy Bell's palsy Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Bell's palsy from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History [wikidoc.org]
Although the ability to predict brachial plexus injury antenatally remains elusive, knowledge of its epidemiology, risk factors, variations in presentation, prognosis, and management can guide therapeutic decisions and potentially avoid lifelong disability [pedsinreview.aappublications.org]
Epidemiology An incidence of 0.8 -1.2 cases per 1000 birth has been reported. No sex predilection has been reported. [boneandspine.com]
Resources Images and videos References View PDF Epidemiology Erb palsy is a type of brachial plexus birth ... ... [sok.helsebiblioteket.no]
Pathophysiology
Nov 16; 55(10):619-25 Collado-Vazquez S, Jimenez-Antona C, Carrillo JM CONCLUSIONS: Since the first clinical description of obstetric brachial palsy by Smellie and the reports of the different types of brachial palsy by Duchenne, Erb and Klumpke, many pathophysiological [unboundmedicine.com]
Bell's palsy Bell's palsy Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Bell's palsy from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History [wikidoc.org]
Relevant Anatomy and Pathophysiology Brachial plexus is formed of nerves roots from C5-T1 vertebra. As these roots come out, C5 and C6 join to form the upper trunk, C7 travels alone as the middle trunk, and C8-T1 join as the lower trunk. [boneandspine.com]
The pathophysiology appears to be thrombophlebitis of the vasa vasorum or an arterial embolism causing ischemic nerve damage ( 9 ). NEUROPATHOLOGY The injury is usually where nerve roots form the trunks of the brachial plexus. [academic.oup.com]
Pathophysiology To understand the clinical presentation of brachial plexus palsy (BPP) and provide anticipatory guidance for families affected by the condition, the clinician must first know basic anatomy. [emedicine.medscape.com]
Prevention
Much of this research is aimed at finding ways to prevent and treat these disorders. Information sourced through CNF’s partnership with The National Institute of Neurological Disorders and Stroke (NINDS), US National Institutes of Health. [childneurologyfoundation.org]
Prevention Most cases of Erb’s palsy in infants can be prevented by: Advanced planning: If the baby is larger than usual or in the incorrect position in the weeks leading up to the due date, advanced planning by the obstetrician to prevent Erb’s palsy [baptisthealth.com]
Prevention of bacterial endocarditis. [books.google.com]
Stimulation 17. splinting -Resting night splints – prevent wrist & finger F contracture -Wrist cock-up – maintain neutral wrist alignment (Klumpke’s Paralysis) -Statue of liberty splint – prevent Add & IR contracture 18. [slideshare.net]
This labor abnormality is not preventable and may contribute, in many ways, to the neurologic complication. [ncbi.nlm.nih.gov]