Brachial Plexus Injury (BPI) also sometimes called Erb’s palsy or ErbDuchenne palsy: The brachial plexus is the group of nerves that send signals from the spine to the shoulder, arm and hand. A brachial plexus injury can affect every child differently. In mild cases, it may cause numbness. In more severe cases, it can impact the arm in various ways from limited use of fingers to limited to no use of the entire arm on the side of the injury. A brachial plexus injury does not directly affect a child’s cognitive development.
Causes: A brachial plexus injury can occur when the nerves are stretched or torn by the shoulder being pushed down forcefully when the head is pushed up and away from that shoulder. This injury can be caused during a traumatic birth, as well as during contact sports, vehicular accidents or falls. It may cause weakness or paralysis of the affected arm.
Possible complications: A brachial plexus injury can cause stiff joints as well as loss of feeling in that arm, which make movement difficult. Left untreated it can also cause permanent muscle atrophy.
Treatment options include:
- Physical Therapy: PT uses stretches and exercises to increase the range of motion and muscle strength while working on gross motor skills, including balance and range of motion.
- Occupational Therapy: OT can help a child learn to adapt to their limitations in order to care for themselves, as well as improving fine motor skills like pinching, writing, and holding utensils to eat.
- Splints/Braces: Splints may be used to prevent the hand from curling in. Braces may be used to help hold the arm in place.
- Surgery: In certain cases, surgery can help increase mobility in the child’s arm. There are several different types of surgery that could be used:
- Nerve graft: In this procedure, the damaged part of the brachial plexus is removed and replaced with sections of nerves cut from other parts of the body.
- Nerve transfer: When the nerve root has been torn from the spinal cord, surgeons can take a less important nerve that’s still attached to the spinal cord and hook it into the nerve that’s no longer attached. Nerve tissue grows slowly, about an inch a month, so it can take several years to fully recover after surgery.
- Muscle transfer: The surgeon will remove a less important muscle or tendon from another part of the body and transfers it to the arm.
Prognosis: Most children with this special need have a normal life span and can lead independent lives. Partly because of the risk of muscle atrophy, surgery to repair brachial plexus nerves should ideally occur within three to six months after the injury. The success rate drops greatly if nerve surgery occurs more than a year after the injury. Most of the children being adopted internationally will not have had any sort of treatment.
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Links for this Special Need:
Stories or Blogs from Families who have Parented a Child with Brachial Plexus Injury: