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The brachial plexus is a network of nerves that carry signals from the spinal cord to the shoulders, arms and hands. An injury to the brachial plexus can severely affect movement and feeling in the arm. The symptoms are typically confined to one side of the body, and they occur in roughly one to two of every 1,000 births worldwide. Fortunately, the frequency of these injuries is declining over time.
An injury that damages the brachial plexus results in a condition that goes by several names depending of the specific part of the nerve that is damaged. Its names include Erb’s palsy, Klumpke’s paralysis and Erb-Duchenne paralysis. It is sometimes called left brachial palsy or right brachial palsy to indicate the side of the body affected.
The symptoms of a brachial plexus injury during childbirth are evident shortly after birth, if not immediately after. They include:
In some instances, the symptoms will fade within a few months. In other cases, however, the symptoms will persist and require surgery or other intervention, which may or may not be successful in returning proper function to the limb. When the symptoms persist beyond the early stages of an infant’s life, it is typically because the affected nerves have been torn from the spinal cord, which is known as avulsion.
Eventual complications include muscle contractions that may permanently tighten muscles, muscle atrophy and complete paralysis of the affected arm.
The Brachial Plexus Palsy Foundation offers information and support for families dealing with this condition.
It is a heavy burden to care for a child with a disability. Visits to the doctor and years of treatments add up in cost and can affect the livelihood of your family. If a medical error during delivery has caused brachial plexus palsy in your baby, you should speak with an attorney at Oshman & Mirisola, LLP to learn how your family can be compensated for your expenses and your hardship.
Pursuing a claim for compensation won’t undo the birth injury your child sustained, but it can provide some peace of mind through financial assistance. It might also help other families avoid the pain yours has endured by forcing the attending doctor and the hospital to undertake stronger efforts to protect babies from preventable injuries during birth.
What Causes Brachial Plexus Palsy?
While serious trauma to a person of any age can damage the brachial plexus, brachial plexus palsy typically stems from a birth injury — an injury sustained to a newborn during the childbirth process. Doctors are trained to know what can cause these injuries, but they still can occur due to negligence, carelessness or accident.
There are several instances during childbirth that can cause an injury to the brachial plexus:
Babies with a higher-than-average birth weight and/or babies born to diabetic mothers are at an increased risk of sustaining an injury to the brachial plexus. There are other factors that can increase the risk of a birth injury, as well; doctors are trained to look for these factors. A Caesarian section may be ordered if the doctor believes a substantial risk of injury exists.
The extent of symptoms, and whether or not they are correctable, depends on the exact nature of the injury sustained to the nerves. There are four different kinds of injuries recognized. From least severe to most severe, they are:
It should be apparent to your doctor after birth if your baby’s arm or hand is not functioning properly. The affected limb will typically flop as the child is turned over, and it will lack a Moro reflex – a standard involuntary reflex a doctor will check for, much like how a doctor might check for the patellar reflex by striking your knee with a hammer. A doctor may order an X-ray or other imaging procedures to get a better look at the affected nerve and to rule out a bone fracture as the cause of the symptoms.
The approach taken in treating brachial plexus palsy changes as a baby grows. At the Brachial Plexus Palsy Clinic at St. Louis Children’s Hospital, the following timeline is followed in addressing these nerve injuries:
Even if surgical intervention is recommended, it is not always successful in returning function to the affected arm. But several procedures are possible, including:
Later in life, additional procedures may be performed the improve function of the arm, including:
If serious symptoms persist after several months, it is unlikely that the nerves will heal on their own.
If this occurs to your baby, there is no guaranteed way to heal the damaged nerve. A regular regimen of exercise and physical therapy will likely continue through much of your child’s youth.
There are two main types of brachial plexus palsy. They result from an injury to a different portion of the nerve, causing different symptoms:
Typically, injuries sustained during childbirth are completely preventable. Brachial plexus injuries normally result from medical error or negligence on the part of the doctor and attending staff. This is because there are several warning signs a doctor should look for – such as the position of the baby, the baby’s size, the mother’s medical history and previous issues during pregnancy, and more. Know these risks and talk to your doctor ahead of time about ensuring a safe delivery. Insist on a Caesarian section if warning signs are present and your doctor doesn’t recommend one.
Even when a vaginal birth is underway, there are steps doctors are trained to take to avoid injuring your baby. Injuries to the brachial plexus are nothing new, and doctors are taught how to prevent them. When they occur, it is typically because of an oversight or error that was completely preventable. It should not happen.