ERB'S PALSY


'Erb's Palsy' ('Erb-Duchenne Palsy', 'Brachial plexus paralysis') is a condition which mainly due to birth trauma can affect 1 or all of the 5 primary nerves that supply the movement and feeling to an arm.
A similar injury may be observed in adults or following a traumatic fall on the side of the neck. It can also affect neonates affected by a clavicle fracture unrelated to dystocia.[1]

Contents
Presentation
Treatment
Discovery
Famous People
See also
References
External links

Presentation


The paralysis can be partial or complete; the damage to each nerve can range from bruising to tearing.
The most commonly involved nerves are the suprascapular nerve, musculocutaneous nerve, and the axillary nerve.[2]

Treatment


Some babies recover on their own; however, some may require specialist intervention.
Neonatal / pediatric neurosurgery is often required for avulsion repair. Lesions may heal over time and function return. Physiotherapeutic care is often required to regain muscle usage.
Although range of motion is recovered in many children under one year in age, individuals who have not yet healed after this point will rarely gain full function in their arm and may develop arthritis.

Discovery


The renowned British obstetrician William Smellie is credited with the first medical description of an obstetric brachial plexus palsy. In his 1768 treatise on midwifery, he reported a case of transient bilateral arm paralysis in a newborn after difficult labour.
In 1861, Guillaume Benjamin Amand Duchenne coined the term "obstetric palsy of the brachial plexus" after analyzing 4 infants with paralysis of identical muscles in the arm and shoulder, after publishing his initial findings in 1855.[2][4] In 1874, Wilhelm Heinrich Erb concluded in his thesis on adult brachial plexus injuries that associated palsies of the deltoid, biceps and subscapularis are derived from a radicular lesion at the level of C5 and C6 rather than isolated peripheral nerve lesions.[5]

Famous People


Famous people afflicted by Erb's palsy were Wilhelm II of Germany,[6] Joseph Stalin, Queen Victoria of Britain and famous Canadian journalist Barbara Frum.
Also, Martin Sheen was injured during birth and developed the condition in his left arm. His difference in arm length and range of motion can be seen in his movies, especially Apocalypse Now.

See also



Klumpke paralysis

Dystocia

References


1. Fractured clavicle and Erb's palsy unrelated to birth trauma, Peleg D, Hasnin J, Shalev E, , , Am. J. Obstet. Gynecol., 1997
2.
3.
4. G. B. A. Duchenne. De l’éléctrisation localisée et de son application à la pathologie et à la thérapeutique. Paris, Baillière, 1855.
5. W. Erb. Ueber eine eigenthümliche Localisation von Lähmungen im Plexus brachialis. Verhandlungen des naturhistorisch-medicinischen Vereins zu Heidelberg, 1874, 2: 130-137.
6. Obstetrical events that shaped Western European history, Ober WB, , , The Yale journal of biology and medicine, 1992

External links



Erb's Palsy Group





Wilhelm Heinrich Erb, M.D. (1840 to 1921): a historical perspective on Erb's palsy, Watt AJ, Niederbichler AD, Yang LJ, Chung KC, , , Plast. Reconstr. Surg., 2007

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