Brachial Plexus Injuries

brachial-plexus-injuryInjuries to the brachial plexus — a group of nerves originating in the neck — can result from a number of causes during the birth process.

A type of brachial plexus injury known as obstetric brachial plexus palsy manifests in fewer than 1 percent of births. This type of birth injury, also referred to as birth related brachial plexus palsy, most commonly occurs during difficult deliveries. In some cases, the infant’s shoulder becomes lodged against the mother’s pubic bone, causing stretching or tearing of the brachial plexus nerves.

The attorneys at Davis Levin Livingston have extensive experience in litigation relating to birth related nerve injuries, including obstetric cases. If you or a loved one have sustained an injury during the birth process, an experienced attorney can assist you in reaching a settlement for the compensation to which you are entitled.

Brachial Plexus Nerve Injuries

Erb’s Palsy

In the majority of cases of obstetric brachial plexus injuries to an infant, the upper nerves are affected. The condition, known as Erb’s palsy, results in loss of mobility in the shoulder. However, infants sometimes retain the ability to move their fingers.

Klumpke’s Palsy

In Klumpke’s palsy, the lower brachial plexus is injured, resulting in loss of motion in the hand and wrist. When upper and lower nerves stretch to the point of injury, the resulting condition is known as a total brachial plexus birth palsy.

Four general categories of injuries to nerves can occur as the result of brachial plexus injuries during birth, and all can occur concurrently in the same child:

  • Neuropraxia: a type of stretch injury that does not tear the nerve and that typically heals on its within approximately three months. This type of injury can occur in both adults and infants.
  • Neuroma: a type of stretch injury leading to damaged nerve fibers and scar tissue, which may press on healthy nerve tissue.
  • Rupture: a serious tearing injury of the nerve.
  • Avulsion: a serious tearing injury of the nerve at the spinal cord. Avulsion injuries cannot be repaired, but some arm function may be restored by using nerve from a different muscle.

Brachial Plexus Injury Symptoms

All types of brachial plexus injuries are marked by loss of feeling, weakness and complete or partial paralysis in one arm. However, severity can vary greatly. The seriousness of the injury affects the recommended treatments and the degree to which a patient may recover.

In obstetric cases, a pediatrician typically makes a diagnosis based on a physical examination. For both children and adults, a doctor may prescribe an ultrasound or another imaging method to determine the extent of damage to joints and bones in the shoulder and neck. This type of injury in an infant or child can impair the growth of the shoulder.

In more serious cases, nerves may sustain permanent damage, including rupture. In the most serious type of injury, avulsion, the nerve is torn from the spinal cord at its root.

Such injuries can cause permanent disability, and patients with even seemingly minor injuries should seek medical attention immediately. Treatment within approximately six months of an injury is critical, because delays can negatively affect the outcome of surgeries to the nerves.

Brachial Plexus Injury Treatment

In some cases, brachial plexus injuries heal without treatment; many infants injured at birth recover by approximately three months of age. If your newborn has suffered an obstetric brachial plexus injury, your pediatrician will examine her frequently to ensure proper healing of the nerves.

For cases that do not heal on their own, recommended treatments include physical therapy and surgery. For Erb’s palsy, physical therapy may be required on a daily basis, and parents must manually work the infant’s muscles and joints using exercises prescribed by the pediatrician.

If the condition does not improve in the first six months, a doctor may suggest nerve surgery using specialized, small instruments and high-powered microscopes. Surgery usually does not fully relieve the results of the injury and may not help older babies.

What is the prognosis for brachial plexus injuries?

For both infants and adults, the site and severity of the brachial plexus injury affect a patient’s chances of recovery. For avulsion and rupture injuries, timely surgery provides the only hope of recovery. In some children who suffer brachial plexus injuries at birth, the impacted arm may be smaller. If you or a loved one has sustained a brachial plexus injury, contact the experienced attorneys at Davis Levin Livingston at (866) 806-4349 to learn about your legal options.