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Erb’s palsy (also called Erb-Duchenne palsy) is an uncommon form of paralysis caused by damage to the upper trunk of cervical nerves attached to the spinal cord known as the brachial plexus. These nerves (C5-C8) control the upper arm muscles, including the deltoids, biceps and brachialis. Erb’s palsy is distinct from Klumpke’s palsy, which damages nerves that control the lower arm and hand. The acute symptoms of Erb’s palsy are an inability to raise the arm, and extension and pronation (turning) of the forearm. If left untreated, Erb’s palsy can impede development of the affected arm, causing further complications, such as muscle atrophy, poor circulation, and an increased susceptibility to infection. Severe birth injury cases can cause individuals to lose all use and feeling in their arm. The most common cause of Erb’s palsy is birth injury caused by shoulder dystocia , or distress during a difficult birth when the baby’s shoulder becomes trapped by the mother’s pelvic bone. Obstetricians should understand the conditions that can lead to dystocia, including large babies, small mothers, prolonged labor, or certain health conditions such as obesity and diabetes . Women who have a prior history of shoulder dystocia during childbirth are more likely to experience it with subsequent births, as well. In cases where the risk of shoulder dystocia are high, doctors should recommend a cesarean section (c-section) instead of a vaginal delivery to avoid potential birth trauma.
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