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Brachial Plexus Palsy

A type of palsy known as brachial plexus palsy is caused by a birth injury to the brachial plexus. The brachial plexus is the network of nerves that control movement and sensation of the arm. Brachial plexus palsy injury results in weak or paralyzed muscles in the shoulder, arm, and hand. While most infants with brachial plexus palsy make complete spontaneous recovery, some continue to suffer with varying degrees of arm weakness.

Infants that do not recover spontaneously from brachial plexus palsy will require physical therapy and occupational therapy, and others will need both therapy and surgery. Deformities that form in the child's shoulder, arm, or hand may need orthopedic treatment. Regardless of the case, treatment for brachial plexus palsy must start early to ensure the greatest improvement.

Brachial plexus palsy is typically diagnosed in the newborn stages. Primary physicians perform brachial plexus palsy diagnosis and refer patients to a multidisciplinary brachial plexus team for treatment. The brachial plexus palsy treatment team works to restore normal function in the infant's arm during the first 2-6 months after birth.

The frequency of brachial plexus palsy is approximately 1 to 2 in 1000 births and significant arm weakness persists in about half of those cases. A varying degree of frequency and persistence of arm weakness due to brachial plexus palsy has been reported. The inconsistency is probably a reflection of the patient population treated at individual brachial plexus palsy centers.


A referral center sees the worst brachial plexus palsy cases and would probably underestimate the prevalence of the birth brachial plexus injury and overestimate the relative persistence of weakness. However, the improvement of obstetrical care has not eliminated brachial plexus palsy birth injury, mainly because of the inherent risk factors.

Brachial plexus palsy occurs by injury to the brachial plexus by traction on the shoulder during delivery. Large infants are usually affected by brachial plexus palsy because it is necessary to use force in pulling them from the birth canal. When the shoulder is forcibly pressed downward, the brachial plexus can be stretched or injured.

The delivery method usually correlates with the type of brachial injury. Infants with upper brachial plexus injury (Erb's palsy) are more likely born by breech delivery, and those with more extensive injury are more likely born headfirst. However, brachial plexus palsy can occur even with cesarean section.

If you suspect that your child suffered brachial plexus palsy at the hands of the delivery team, you may have a medical malpractice case. Because these cases can be extremely difficult to prove, an experienced birth injury lawyer can help organize your case. Contact an experienced cerebral palsy lawyer to evaluate your brachial plexus palsy case.


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