Erb's Palsy

Health Topics

bells palsyErbʼs Palsy (Erbʼs-Duchenne Paralysis) is defined as a brachial plexus paralysis, secondary to trauma of the upper trunk (C5-C6) of the brachial plexus. Brachial plexus injuries are most commonly seen in newborns and are usually caused by traction and excessive lateral flexion of the head and neck during delivery.

Chiropractic adjustments and Erbʼs Palsy: a case study. Hyman CA, Journal of Clinical Chiropractic Pediatrics. Oct. 1997;2(2) pp. 157-60..

Chiropractic care of a patient presenting to the authorʼs chiropractic office, with obstetrical brachial plexus injury at the level of C5-C6 nerve roots (Erbʼs Palsy). Brachial plexus injuries are most commonly seen in newborns and are usually caused by traction and excessive lateral flexion of the head and neck during delivery.

Patient: A two-month old black female presented with obstetrical brachial plexus injury (Erbʼs Palsy). This infant had been under the care of several medical pediatricians without resolution.

Conclusion: The infant had complete resolution of her condition with no complications or residual impairments under chiropractic care. Resolution of infantile ERB’s palsy utilizing chiropractic treatment.. Biedermann H; J Manipulative Physiol Ther 1994; 17(2):129-31

Seventy five percent of cases of Erb-Duchenne palsy (Erb’s palsy) improved markedly, and far quicker than in the three week period waiting period before chiropractic treatment

Resolution of infantile Erbʼs palsy utilizing chiropractic treatment. Harris SL, Wood KW JMPT 1993,16:415-418.

A 5-wk-old infant boy suffered from a limp left arm. Birth records were obtained to verify the diagnosis.. The patient received specific chiropractic adjustments to the midcervical. The Erb’s palsy resolved with only a mild residual “waiters tip” deformity within 2 months. In this case, chiropractic adjustment is suggested as an effective treatment for Erb’s palsy. Further research is warranted to understand the efficacy of chiropractic care.

Causes of Erb’s Palsy:

Birth Trauma and Erb’s Palsy.

The incidence of Erb’s palsy in our population is similar to that of other reported studies and has remained unchanged over the past 30 years, even as our cesarean rate has risen from 5% to 20%.

In other words, there is as much force used during c-section deliveries as with vaginal deliveries.

Graham EM; Forouzan I; Morgan MA. A retrospective analysis of Erb’s palsy cases and their relation to birth weight and trauma at delivery. J Matern Fetal Med 1997; 6(1):1-5 Facial nerve palsy in the newborn: incidence and outcome.

Among 44,292 infants born between October 1, 1982 and July 31, 1987, there were 92 recorded cases of congenital seventh nerve palsy. Of these ‘81 were acquired’ for an incidence of 1.8 per 1,000. Seventy-four of the 81 (91%) were associated with forceps delivery.

Falco NA; Eriksson E. Facial nerve palsy in the newborn: incidence and outcome.. Plast Reconstr Surg 1990; 85(1):1-4

Erb’s Palsy Most Common Injury

Erb’s palsy is the most common obstetric brachial plexus injury followed by total plexus palsy. The distribution of Klumpke’s birth palsy with modern obstetric practice is unknown

al-Qattan MM; Clarke HM; Curtis CG. Klumpke’s birth palsy. Does it really exist? J Hand Surg ÍBrÍ 1995; 20 (1):19-23

Erb’s Palsy: Delivery Methods and Baby’s Weight

When birth weight was controlled for in the analysis, midforceps vacuum, and low forceps remained significantly associated with the Erb’s palsy. These data demonstrate a high risk for serious birth injury associated with instrumental midpelvic delivery. McFarland LV; Raskin M; Daling JR; Benedetti TJ. Erb/Duchenne’s palsy: a consequence of fetal macrosomia and method of delivery. Obstet Gynecol 1986; 68(6): 784-8