During birth or later in life, a muscle weakness in the arm or shoulder may be caused by an injury which is called Erb’s palsy. In most cases, Erb’s palsy occurs when an infant’s shoulder is injured during delivery. Although some cause resolves on their own, your healthcare provider may suggest exercises to help prevent permanent stiffness.
The cost of Erb's Palsy surgery may vary based on the patient's specific surgical needs, surgeons' fees, and way of treatment and hospital fees.
This condition is characterized by arm weakness and loss of motion. Erb’s palsy can occur in both infants and adults. In most newborns with this condition, physical injury during birth or traumatic force downward on the upper arm and shoulder can cause damage to the brachial plexus.
Erb's palsy results from injury to nerve roots C5 and C6. The classical sign of Erb's palsy is the arm hanging limply from the shoulder with internal rotation of the forearm plus wrist and finger flexion.
Newborns may develop Erb’s palsy during delivery. This may occur while your healthcare provider has to shift the baby’s head to one side to get their shoulders out, causing the brachial plexus nerves (from the neck to the shoulder) to stretch or even tear. A newborn can also develop Erb's palsy due to the way they were laying in the uterus during pregnancy and once labor begins.
Erb’s palsy, also known as Erb-Duchenne paralysis, is a nerve condition that results in weakness or loss of muscle function in the shoulder and arm. It primarily affects the upper group of the arm’s main nerves, specifically the severing of the upper trunk C5–C6 nerves. These nerves form part of the brachial plexus, a group of five nerves that connect the spine to the arm and hand. These nerves allow your shoulders, arms, and hands to feel and move.
Erb’s palsy can occur as a result of an injury sustained during birth or later in life. It’s most common in infants who injure their shoulders during delivery. Some cases resolve on their own, but healthcare providers may suggest exercises to help prevent permanent stiffness. There are four types of brachial plexus injuries associated with Erb’s palsy:
Avulsion, where the nerve rips away from the spine.
Rupture, where the nerve is torn, but not from the spine.
Neuroma, where the nerve has torn and healed but has left scar tissue that puts pressure on the injured nerve and prevents it from conducting signals to the muscles.
Neurapraxia, where the nerve is stretched but not torn. This is the most common type of brachial plexus injury.
Newborns sometimes develop Erb’s palsy during a difficult vaginal childbirth, or even during a cesarean section. During delivery, healthcare providers sometimes have to move the baby’s head to one side to make room for the delivery of their shoulders. In some cases, the stretching of the nerves causes damage, possibly even tears. This type of Erb’s palsy is also called a brachial plexus birth palsy, obstetric brachial plexus palsy, or brachial plexus birth injury.
Erb’s palsy primarily affects newborns and can sometimes develop during a difficult vaginal childbirth, or even during a cesarean section. During delivery, healthcare providers sometimes have to move the baby’s head to one side to make room for the delivery of their shoulders. In some cases, the stretching of the nerves causes damage, possibly even tears. This type of Erb’s palsy is also called a brachial plexus birth palsy, obstetric brachial plexus palsy, or brachial plexus birth injury.
Erb’s palsy can also happen to adults who have traumatic injuries. It primarily affects the upper group of the arm’s main nerves, specifically the severing of the upper trunk C5–C6 nerves. These injuries arise most commonly, but not exclusively, from shoulder dystocia during a difficult birth.
Depending on the nature of the damage, the paralysis can either resolve on its own over months, necessitate rehabilitative therapy, or require surgery. The paralysis can be partial or complete; the damage to each nerve can range from bruising to tearing.
Erb’s palsy occurs in 0.9 to 2.6 per 1,000 live births or nearly 12,000 cases per year. It’s most common in larger infants who need to be pulled out during delivery because they’re stuck. Symptoms and Causes What are the signs and symptoms of Erb’s palsy? Erb’s palsy affects the shoulder, arm, and elbow. In general, your hand muscles aren’t affected, but your hands may experience tingling or numbness.
Traffic accidents involving motorcycles usually cause brachial plexus injuries in teenagers and adults. Some other causes include gunshot or knife wounds, industrial accidents, accidents related to contact sports like football, surgical complications, or tumors.
There are four types of brachial plexus injuries:
Avulsion: The nerve rips away from the spine and is the most serious type of Erb's palsy.
Rupture: The nerve is torn, but not from the spine.
Neuroma: The nerve has torn and healed but has left scar tissue. The scarred tissue puts pressure on the injured nerve and prevents it from conducting signals to the muscles.
Neurapraxia: The nerve is stretched but not torn (also the most common type of injury).
Erb’s palsy, also known as Erb-Duchenne paralysis, is a condition that results in weakness or loss of muscle function in the shoulder and arm. The signs and symptoms of Erb’s palsy can vary in severity and may be temporary or permanent. Here are some common signs and symptoms of Erb’s palsy:
Weakness or Paralysis: One of the most noticeable signs of Erb’s palsy is weakness or paralysis in the arm, shoulder, or elbow joint. The affected arm may appear limp or paralyzed.
Tingling and Numbness: Individuals with Erb’s palsy may experience tingling and numbness in the arm or hand. This can be a result of damage to the nerves that provide sensation to these areas.
Reduced Grip Strength: Another common symptom is reduced grip strength in the hand. This can make it difficult for the individual to grasp objects or perform tasks that require fine motor skills.
Abnormal Arm Position: The affected arm may be held in an awkward position. For example, the palm of the hand may be curved backward, and the fingers may be curled.
Lack of Movement: One of the first signs a doctor or new parent may detect in an infant is a lack of movement or weakness in the affected arm3. Although motor control is limited in newborns, infants move their arms around right after birth. If one arm moves and the other does not, it is likely a sign of Erb’s palsy.
These symptoms can range from mild to severe, depending on the extent of the nerve damage. It’s important to consult with a healthcare provider if you notice any of these symptoms in yourself or your child, as early intervention can improve the prognosis.
Erb’s palsy is diagnosed through a combination of physical examination and diagnostic tests. During the physical examination, healthcare professionals check for symptoms such as weakness or paralysis in the affected arm, lack of movement in the hand or arm, and decreased reflexes. To determine the severity of the Erb’s palsy, one or more of the following tests may be required:
X-ray: An X-ray of the shoulder and neck can show fractures or other related injuries.
Electromyography (EMG): This test measures the electrical activity of the muscles to assess their health and the nerves controlling them.
Neurological and Sensation Assessments: These assessments study your child’s muscle tone, reflexes, spontaneous movements, and sensations.
Movement and Motor Tests: There are two main motor and movement tests doctors can conduct to assess for Erb’s palsy: the passive range-of-motion (PROM) examinations and the active movement scale (AMS).
Imaging and Electrodiagnosis: These tests can help visualize the brachial plexus and assess the extent of nerve damage.
These tests help healthcare professionals understand the extent of the nerve damage and guide the treatment plan. It’s important to note that the symptoms of Erb’s palsy can vary in severity and may be temporary or permanent. Therefore, early diagnosis and intervention can improve the prognosis.
The treatment of Erb’s palsy depends on the severity of the injury. Some cases may resolve by themselves within three to four months. However, most likely, healthcare providers will suggest that you do exercises and physical therapy with your baby from about the age of three weeks.
Non-Surgical Treatments: Daily physical therapy is the most effective treatment for Erb’s palsy. This involves a series of exercises that parents can do at home with their child. These exercises help maintain the range of motion in the baby’s arm and prevent stiffness. They also help improve blood circulation to the affected nerves, which can promote healing.
Surgical Procedures: If physical therapy doesn’t show promising results after three to six months, your physician may recommend surgery to repair damaged nerves. The type of surgery depends on the severity of the nerve damage. For example, for avulsion injuries where the nerve is torn from the spinal cord, a nerve graft or nerve transfer may be performed. For less severe injuries, neurolysis (the removal of scar tissue from the nerve) may be sufficient.
Post-Treatment Rehabilitation: After treatment, whether non-surgical or surgical, ongoing physical therapy and occupational therapy are usually needed. These therapies help improve fine motor skills, strength, and function in the affected arm.
Complications: Most infants and older patients with Erb’s palsy will recover strength and movement in the affected arm. However, some may experience lasting effects, such as limited movement or reduced muscle control.
The treatment of Erb’s palsy involves a combination of physical therapy, possibly surgery, and post-treatment rehabilitation. The specific treatment plan depends on the severity of the condition and the individual’s response to therapy.
Equipped hospitals, and advanced specialized centers with experienced doctors and specialists are available in all medical treatment areas in Iran. Also, good hotels and entertainment centers have made Iran an appropriate choice for patients who are dealing with Erb's Palsy and need surgery.
The cost of Erb’s palsy treatment in Iran can vary based on the patient’s specific surgical needs, surgeons’ fees, and hospital fees. Iran is known for its advanced medical facilities and experienced doctors, making it a popular destination for patients seeking affordable treatment.
While the exact cost of Erb’s palsy treatment in Iran may vary, it is generally significantly lower than in many other countries. This affordability is due to various factors, including lower living costs and medical expenses. The cost of Erb’s palsy treatment in Iran ranges around 2000-2500 USD.
However, it’s important to note that the final cost can vary depending on individual circumstances and additional medical needs. Therefore, it’s always recommended to consult with healthcare professionals and conduct thorough research when considering medical procedures abroad.
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