Cerebral Palsy & Erb's Palsy

Some of the most common birth defects (or injuries) are two very different conditions known as cerebral palsy and Erb's (or brachial) palsy. Both cerebral and Erb's palsy are often the result of complications during child delivery itself, though cerebral palsy can sometimes occur before or some time after delivery.

Cerebral Palsy

Cerebral palsy is the generic term for a number of disorders affecting a baby's brain function and body movement. Cerebral palsy can be the result of an injury to a baby's brain in the womb, during delivery, or some time after birth. It can also be caused by a lack of oxygen flow to a baby's brain during delivery.

Some situations that can cause or contribute to cerebral palsy include:

• A treating physician/obstetrician's failure to recognize the need to provide adequate oxygen to the baby, such as by caesarean section, or unreasonable delay in performing the procedure;
  
  
• A mother's use of a harmful prescription drug during pregnancy
  
  
• Prolonged bleeding in the baby's brain after delivery, usually due to head trauma
  
  
• Extremely premature birth
  
  

Symptoms of cerebral palsy in a child may take some time to show up, but can include the following: slow development in terms of rolling over, crawling, smiling, and talking; abnormal or decreased muscle tone, or "floppiness" of limbs; unusual posture; poor co-ordination; involuntary movements; and vision or hearing problems.

Erb's (or Brachial) Palsy

Erb's (or brachial) palsy occurs in about two out of every 1,000 child deliveries, when a baby suffers injury to the brachial plexus The brachial plexus is a group of nerves that travel from the spinal cord up the arm, supplying the arms and hands. Erb's palsy happens most often during delivery when excessive pressure is put on the baby's head, neck, or shoulder because of difficulty delivering the shoulder area (known as "shoulder dystocia"). The condition occurs most frequently in babies of higher-than-average birth weight, and can happen when forceps or vacuum devices are used with too much pressure during delivery. The brachial plexus is simply stretched too far until important nerves are torn or ruptured. Symptoms of Erb's palsy can include paralysis or limpness in a baby's arm, limited or no movement in hands and fingers, and loss of sensation in the hands and fingers. Often the baby will simply hold the affected arm very close to the body, and will appear to be unable to move the arm itself, the hands, or the fingers.

Complications from the condition known as Erb's palsy are typically the result of a treating physician/obstetrician's:

• Failure to recognize that a caesarean section should have been performed, based on the baby's size
  
  
• Failure to adequately deliver the baby in situations involving "shoulder dystocia"
  
  
• Use of excessive pressure on the baby's head, neck, or shoulder during delivery
  
  

Erb's palsy usually results in a baby's inability to fully rotate and flex his or her arm, and if a nerve is torn during delivery, permanent nerve damage may result. If no tearing has occurred, bruising and swelling around the nerve should subside and normal movement become possible in a few months. If a baby is diagnosed with Erb's palsy, treatment and therapy such as immobilization of the arm and special exercises may help to improve or eliminate the condition. If the condition is severe or permanent enough, surgery may be necessary to correct the problem.

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