Erb Palsy (Erb-Duchenne Palsy)

OVERVIEW

Erb Palsy (Erb-Duchenne Palsy) refers to a paralysis of the arm that is caused by the injury of the brachial plexus. Specifically, this condition is caused by the the severing of the upper trunk which contains the C5/C6 nerves.

Damage to the upper trunk of the brachial plexus (containing nerves from C5 and C6) is typically responsible for Erb palsy (source)
Damage to the upper trunk of the brachial plexus (containing nerves from C5 and C6) is typically responsible for Erb palsy (source)
WHAT CAUSES IT?

Often times traumatic injuries are responsible for this condition. Shoulder dystocia during a difficult birth is a common cause.

WHAT MAKES US SUSPECT IT?

Risk Factors:

Difficult delivery (i.e. shoulder dystocia)

Initial Presentation:

  • Adducted and internally rotated arm

Musculoskeletal Exam:

Patient with bilateral Erb palsy showing arm abduction and internal rotation clearly (source)
Patient with bilateral Erb palsy showing arm abduction and internal rotation clearly (source)

Findings include:

  • Arm that is tonically adducted and internally rotated
  • Intact grasp reflex
HOW DO WE TREAT IT?

Initial Treatment Involves Reassurance And Waiting: typically this condition will self resolve on its own by 3-6 months of age.

Neuroplasty If Conditoin Persists: this treatment is performed if this condition persists beyond 3-6 months of age.

 

Page Updated: 11.30.2016