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Brachial Plexus Birth Injury

What You Need to Know
  • Injury to the brachial plexus is fairly common during the birth process, occurring in one to two births per 1,000.
  • Larger babies in difficult vaginal deliveries are particularly prone to this injury, as are babies of diabetic mothers.
  • Up to one in 10 babies with brachial plexus injury will require some level of surgery.
  • The condition is also known as an obstetric brachial plexus injury.

What is a brachial plexus birth injury?

The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands.

In adults, brachial plexus injuries are the result of trauma such as falls or motor vehicle accidents. In babies, the brachial plexus nerves in the shoulder are vulnerable during the birth process.

The condition generally takes one of two forms:

Erb’s Palsy

Erb’s palsy is an injury of the upper brachial plexus nerves, causing loss of motion around the shoulder and an inability to flex the elbow.

Klumpke’s Palsy

Klumpke’s palsy affects the lower brachial plexus, leading to loss of motion in the wrist and hand.

Symptoms of a Brachial Plexus Injury

Children and babies with brachial plexus injuries may experience:

  • Numbness or tingling or pain in their arm, hand, or fingers

  • Inability to:

    • Lift their arm above their head

    • Bring objects to their mouth

    • Move their fingers

Imaging studies using MRI scans may help a doctor confirm the diagnosis.

Brachial Plexus Birth Injury Treatment

The seriousness of these injuries can vary widely. Some children with brachial plexus birth injuries recover spontaneously, and most children will regain all or most of their normal function through occupational therapy. Early diagnosis and treatment can improve long-term results.

If no improvement is seen after three months of occupational therapy, however, consulting a pediatric neurologist and pediatric neurosurgeon can help determine if your child can benefit from other interventions or surgery.

Prompt intervention is important. If the injury occurred during the baby’s birth, the best time for surgery is when your child is between 4 and 9 months, as waiting more than a year can reduce the chances of improvement with surgery.

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