What is Brachial Plexus?
The brachial plexus is a bundle of nerves that runs from the spine through the neck and armpit region into the arm. In a difficult childbirth or as a result of medical malpractice, the brachial plexus may become injured if the shoulder and neck are stretched or distorted. This often occurs when the infant is large or the birth canal is too small.
During the infant’s passage through the birth canal, the shoulders may be unable to pass through after the head, resulting in physical manipulation being necessary to complete the delivery. At this time, the brachial plexus may become injured. Depending on the extent of the injury, partial or total paralysis of the affected arm may result. In some cases, a brachial plexus injury may heal on its own. If a severe injury is sustained, however, surgery and physical rehabilitation may be necessary to help a child regain feeling and control in the affected arm.
Causes of Brachial Plexus Birth Injuries
Brachial plexus birth injuries are injuries to the nerves that control movement and feeling in the arm. They can occur during childbirth, especially if the baby is large or if the delivery is difficult. The most common causes of brachial plexus birth injuries are:
- Breech birth: A breech birth is when the baby is born bottom-first. This can put more stress on the nerves in the brachial plexus.
- Prolonged labor: A prolonged labor is when the delivery takes longer than usual. This can also put more stress on the nerves in the brachial plexus.
- Forceps or vacuum delivery: Forceps and vacuum extractors are sometimes used to help deliver a baby. However, these instruments can put stress on the nerves in the brachial plexus.
- Large baby: A large baby is more likely to injure the nerves in the brachial plexus during delivery.
- Difficult delivery: A difficult delivery is one that is complicated by factors such as shoulder dystocia or a malpresentation. This can increase the risk of brachial plexus injury.
Brachial plexus birth injuries are most common in first-born babies, babies born to mothers who have had a previous brachial plexus birth injury, and babies who are large for gestational age.
Symptoms of Brachial Plexus
The symptoms of a brachial plexus injury can vary depending on the location and severity of the nerve damage. Here are some common symptoms associated with brachial plexus injuries:
- Weakness: One of the most noticeable symptoms is weakness in the affected arm. The degree of weakness can range from mild to complete paralysis, depending on the severity of the injury.
- Limited Range of Motion: The affected arm may have a limited range of motion, making it difficult for the individual to move or extend their arm, shoulder, or hand fully.
- Loss of Sensation: There may be a loss of sensation or numbness in the arm, shoulder, or hand. The individual may have difficulty feeling touch, temperature, or pain in the affected area.
- Muscle Atrophy: Over time, muscle atrophy (shrinkage) may occur in the affected arm due to the lack of proper nerve stimulation and use.
- Abnormal Muscle Contractions: In some cases, brachial plexus injuries can result in abnormal muscle contractions or spasms in the affected arm. This can lead to involuntary movements or muscle stiffness.
- Claw Hand or Flattened Hand: Depending on the specific nerves involved, the hand may take on a characteristic appearance. It may appear flattened or have a claw-like deformity, with the fingers flexed or extended in an abnormal position.
- Lack of Reflexes: Reflexes controlled by the brachial plexus, such as the Moro reflex or biceps reflex, may be absent or diminished in the affected arm.
The severity and specific symptoms of a brachial plexus injury can vary. Mild injuries may resolve spontaneously over time, while more severe injuries may require medical intervention and rehabilitation, including physical therapy and, in some cases, surgical intervention. If you suspect a brachial plexus injury, it’s important to consult with a healthcare professional for proper evaluation, diagnosis, and treatment.
Types of Brachial Plexus Birth Injuries
There are four main types of brachial plexus injuries:
- Erb’s palsy: This is the most common type of brachial plexus injury. It is caused by damage to the upper nerves of the brachial plexus. Symptoms of Erb’s palsy include weakness or paralysis of the shoulder, elbow, and wrist, and numbness or tingling in the hand.
- Klumpke’s palsy: This is a less common type of brachial plexus injury. It is caused by damage to the lower nerves of the brachial plexus. Symptoms of Klumpke’s palsy include weakness or paralysis of the hand and fingers, and numbness or tingling in the forearm and hand.
- Total brachial plexus palsy: This is the most severe type of brachial plexus injury. It is caused by damage to all of the nerves of the brachial plexus. Symptoms of total brachial plexus palsy include complete paralysis of the arm and hand, and numbness or tingling in the entire arm.
- Neuropraxia: This is a mild type of brachial plexus injury. It is caused by a temporary stretching or compression of the nerves. Symptoms of neuropraxia usually go away on their own within a few weeks.
- Avulsion: Avulsion is the most severe type of brachial plexus injury. It occurs when the nerves are torn away from the spinal cord. Avulsion often results in complete loss of function and requires surgical intervention for repair, such as nerve grafting or nerve transfer procedures.
The treatment for brachial plexus injuries depends on the type and severity of the injury. The severity of the injury can also vary, ranging from mild stretching or compression of the nerves to complete nerve tears. Mild injuries may only require physical therapy, while more severe injuries may require surgery. Physical therapy can help to improve range of motion, strength, and coordination in the arm. Surgery may be used to repair torn or stretched nerves.
Prognosis For Brachial Plexus Birth Injuries
The prognosis for brachial plexus birth injuries varies depending on the severity of the injury. Mild injuries usually have a good prognosis, while more severe injuries may have a poorer prognosis. About 85% of babies with brachial plexus birth injuries will recover completely within 6 months. About 10% will have some residual weakness or numbness, and about 5% will have permanent paralysis.
The prognosis for brachial plexus birth injuries is also affected by the baby’s age at the time of injury. Babies who are injured at birth have a better prognosis than babies who are injured later in infancy. The treatment of brachial plexus birth injuries also plays a role in the prognosis. Babies who receive early and aggressive treatment are more likely to have a good outcome.
Did Your Child Suffer a Brachial Plexus Injury? Call Pacific Attorney Group Now!
If you went through a difficult childbirth and your child suffered brachial plexus injury or has been diagnosed with Erb’s Palsy, please contact a lawyer at Pacific Attorney Group today. We represent clients throughout California in birth injury claims involving brachial plexus injuries. You may have been the victim of medical malpractice or negligence on the part of the doctor, nurse or any medical professional involved during the pregnancy or delivery.
Depending on the case, you may be able to bring a civil lawsuit against the responsible party in order to seek financial damages for your child’s injuries. This may be exactly what you need to cover surgery, physical therapy or any other treatment needed to give your child the best opportunity at making a full recovery.