Brachial plexus injuries affect the nerve network that provides feeling and muscle control in the shoulder, arm, forearm, hand, and fingers.
In newborns, these injuries can happen if:
There are different kinds of brachial plexus (BRAY-kee-ul PLEK-sis) injuries. Depending on where the nerve damage is, the injuries sometimes are called neonatal brachial plexus palsy, brachial plexus birth palsy, or Erb's palsy.
During childbirth, a brachial plexus injury can happen if the baby's neck is stretched to one side.
The brachial plexus nerve network begins with nerve roots at the spinal cord in the neck and reaches to the armpit. Nerves branch out from there and continue down the arm to the forearm, hand, and fingers.
When a strong force increases the angle between the neck and shoulders, the brachial plexus nerves might stretch or tear. The injury may also pull the nerve roots of the brachial plexus from the spinal cord. Damaged nerves carry sensation poorly and make muscle movements weak.
Signs of a brachial plexus injury usually include:
Neonatal brachial plexus injuries are a common type of birth injury (2 to 3 for every 1,000 births). Yet, identifying them in newborns can be hard. Doctors will check the affected arm for paralysis, numbness, position, and grip strength. They also will check a baby's Moro reflex (startle response). This is when a baby throws out the arms and legs, then curls them in when startled.
A specialist who treats infants with these injuries usually oversees the tests and treatments. The specialist might order:
Most babies with a brachial plexus injury regain both movement and feeling in the affected arm. In mild cases, this might happen without treatment.
Other babies might need daily physical therapy. A physical therapist will show parents exercises to do at home to help their baby get better. Massage techniques also can help.
For a more severe injury, a child will be cared for by a team of specialists from:
If pain, weakness, or numbness continue, surgery often can help. Surgical treatments include:
After surgery, it may take 8 months or longer for new nerve function to show. Improvements in strength, range of motion, and control may continue for up to 18 months or more after surgery.
It's important to diagnose and treat a brachial plexus injury as quickly as possible. Early treatment offers the best chance for a baby's fullest recovery.
Reviewed by: Christopher A. Gegg, MD
Date Reviewed: 01-06-2018