Erb's Palsy Klumpke's Palsy Brachial Plexus Injury


Help for families whose children have erb’s palsy and klumpke’s palsy

A brachial plexus injury occurs when the nerves that connect your spine to your arm and hand are damaged. When this injury occurs during childbirth, the result is usually Erb’s palsy, which affects the nerves between the shoulder and the elbow, or Klumpke’s palsy, which affects the nerves in the hand. Depending on the severity of the injury, a victim may never regain full mobility.

At Paulson & Nace, PLLC, we help families just like yours handle the aftermath of serious birth injuries such as those affecting the brachial plexus nerve network. For the last four decades, we have fought for families throughout Washington, D.C. securing millions of dollars in compensation for their injured children.

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How do you get a brachial plexus injury?

A brachial plexus injury occurs when the nerves are damaged during childbirth. This is often the result of shoulder dystocia, a condition where the baby’s shoulder is improperly positioned or is too wide to fit through the birth canal correctly and becomes stuck on one side of the pubic bone after the head has come through. If the doctors fails to address the condition, or does not take the necessary precautions to avoid birth trauma, he or she may be held liable for the injuries your child sustains.

What are the four types of brachial plexus injuries?

According to the National Institutes of Health, there are four types of brachial plexus injuries:

  • Neuropraxia, or stretch. Neuropraxia injuries are the most common and the least severe. They occur when the nerve has been injured in some way, but it has not torn. Most neuropraxia injuries will heal themselves, though it is possible – in about 10% of cases – they will not.
  • Neuroma. Neuroma injuries are tears that have healed themselves, like neuropraxias, but the scar tissue is pressing on the nerve. The scarring prevents the child’s muscles from receiving any signals from the nerves themselves.
  • Rupture. A rupture of the brachial plexus nerve occurs when the nerve itself tears. It remains attached to the spinal column.
  • Avulsion. Avulsion injuries are the most severe; this is when the nerve has been torn from the spinal column. If left untreated, the affected arm may be paralyzed in some manner for the rest of the child’s life.

Each category may require additional medical help for your child to regain the full use of his or her shoulder, arm, or wrist. Unlike cerebral palsy, which may take years to manifest, Erb’s palsy and Klumpke’s palsy can both be immediately apparent in newborns and confirmed with testing. It is crucial that the doctor determine which type of brachial plexus injury your child has sustained as quickly as possible, before too much time passes for the injury to be fixed.


What are the symptoms of a brachial plexus injury?

Erb’s Palsy and Klumpke’s Palsy are similar in that both originate from nerve damage to the brachial plexus. They also both share some symptoms but there are definite signs that distinguish one from the other.

Erb's Palsy

  • Affected Nerves: Erb's palsy results from damage to the upper nerves of the brachial plexus.
  • Symptoms:
    • Loss of feeling in the arm
    • Partial or total paralysis of the arm
    • Weakness in the arm and shoulder
    • Classic "waiter's tip" position of the affected arm.

Klumpke's Palsy

  • Affected Nerves: Klumpke's palsy occurs when the lower nerves of the brachial plexus are damaged.
  • Symptoms:
    • Shares symptoms with Erb's Palsy:
      • Loss of feeling in the arm
      • Partial or total paralysis of the arm
      • Weakness in the arm
    • Specific to Klumpke's Palsy:
      • Atrophy (wasting away) of forearm or hand muscles
      • "Claw hand" appearance (flat forearm, tightened wrist and fingers)
      • Horner's syndrome (drooping eyelid on one side)
      • Hand weakness or inability to use hand muscles
      • Numbness in the hand
      • Pain, potentially severe
      • Stiffness in wrist and hand joints

Any of these symptoms can cause extreme interference with the ability of your child to grow and thrive as he or she would have without being negligently injured. It can affect daily living, the occupation your child may be able to enter, whether he or she will be able to drive a car and just have the life in general that you planned for yourselves.

How do you treat a brachial plexus injury?

Because your child is so young it can sometimes be difficult to diagnose Erb’s Palsy or Klumpke’s Palsy, which requires initiating a battery of tests to confirm an injury was inflicted. Identifying one of these conditions can be done by using:

  • X-ray to show fractures or other associated injuries.
  • Electromyography (EMG), which is the insertion of a needle electrode into various muscles that evaluates electrical activity when they contract and are at rest.
  • Nerve conduction studies measuring the speed of conduction in your nerve to determine how well the nerve functions.
  • Magnetic resonance imaging (MRI) uses radio waves to produce multi-plane views of your body to display detailed damage and to assess whether reconstruction is possible to repair the limb.
  • Computerized tomography myelography (CT) merges multiple X-rays to obtain cross-sectional images of your body using a contrast dye injected into the spine to highlight anomalies in the spinal cord and nerve roots.

To give your child the best possible outcome after it has been determined that the nerve damage was caused by a birth injury, there are various avenues of treatment available that should be explored. Some of the injuries your child may be experiencing will become permanent without taking the proper corrective measures below:

  • Physical therapy
  • Medication
  • Muscle or nerve transfer surgery
  • Nerve grafting
  • Time for slowly recovering nerves to reach maximum healing
  • Rehabilitation therapy after surgical procedures

Most treatments take weeks or months before seeing improvement, but others can take years to fully recover, if ever.

Paulson & Nace understands how devastating these injuries can be for both your child and your family. We hold negligent doctors responsible when their errors – such as delaying a necessary C-section, or using excessive force while trying to deliver the baby – have long-term or even permanent repercussions. If your child was the victim of negligent medical care, we want to hear your story.

Creating options for parents of babies with brachial plexus injuries in Washington, D.C.

The justice-driven attorneys of Paulson & Nace, PLLC, have spent over 40 years protecting new parents and newborns in the greater Washington, D.C. metro area. If your child has suffered Erb’s Palsy or Klumpke’s Palsy after a brachial plexus injury at birth, we may be able to help you obtain the financial support you will need to provide the treatment your child will require to heal. Schedule your free case evaluation in our Washington, D.C. or Charleston, WV office by calling 202-463-1999 or by reaching out to us through our contact page.