Erb’s palsy

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What is it?

Erb’s palsy, paralysis or birth defect is a condition that arises as a result of dystocia, where the neck is stretched in a direction away from the shoulder during the birth process. This leads to a cut, injury, or laceration in the nervous plexus feeding the upper limb and affected at both the motor and sensory levels, and the nature varies. The affected area of ​​the arm depending on the affected area of ​​the nerve plexus.

*It is possible for the child to recover and the nerves return to heal again, and the birthplace will disappear on its own with the passage of time and if it does not recover, in this case the child needs physical therapy, and in difficult cases, surgical intervention may take place.

*In general, cases of childbirth appear clearly in the first days of the child’s life, so if you notice on your child imbalance movement of one of the two parties, treatment must start early, and physical therapy may start on the tenth day of the child’s birth.  

Erb’s palsy

What are other possible causes of its occurrence:

1-If the baby’s head tends to one direction during childbirth; the arm may be pulled in the other direction, causing the bleaching

2-If the baby’s face comes out and the rest of the body cannot slip so; the shoulder may be stretched abnormally during birth.

3-Often what happens if the size of the child is much greater than that of the birth canal itself in a way that allows it to slide and ease?

4-If the pregnant woman was traumatized in the first months of pregnancy; this may lead to this condition, so you must take good care of yourself.

Glimpse: The word paralysis here denotes weakness in the arm and paralysis is not in the literal sense of the word.

Types:

There is an old classical basic division of birth delivery dealing with the affected parts of the arm, but there is another classification dealing with the extent of damage to the nerve fed to the arm. We will review the two divisions separately.

First plot:

1-Erb’s palsy

In the upper limb of the nerve lining of the arm, the injury is particularly in the nerve roots of the cervical nerve 5, 6, 7. The upper part of the arm and shoulder is paralyzed in the muscles responsible for moving the arm in lateral lateral movement, as well as rotation outward.

The negative effect stabilizes the arm in one direction and takes the position of rotation inward toward the upper surface of the palm, as the child loses the ability to straighten his fingers.

2-Klumpek’s palsy

The injury is in the lower part of the nerve plexus, which feeds the arm, particularly in the roots of the first thoracic nerves. The impact area includes the elbow and the hand cuff where the elbow takes the position of the fold, and the arm is facing toward the inside of the hand, and is accompanied by the weakness of the small muscles responsible for moving the hand.

The word Erb paralysis comes from the doctor Erb, who documented the case of birth for the first time in history.

The second plot:

It mainly deals with the extent of damage to the nerve, where the nerve is stretched or worn out, or maybe torn and damaged in severe cases…

1-Neurapraxia

It is the most common type in childbirth cases and it is the simplest and easiest to deal with. In this case, nerve dilation occurs, with the patient continuing to feel burning pain in parts of the affected area. The good thing about this type is that all the nerves affected by the nerve can heal on their own as the nerve returns and returns to its original location. But the difficulty lies in the place that the child often suffers from severe discomfort and severe pain during this time. But in general, the nerve corrects its position on its own in about three months. This means that the child’s growth and movement are more likely to develop very naturally.

2-Neuroma

In this case, nerve dilation is also noticed. And the damage is really serious enough to heal the nerve tissue and leave it scarred. The bad thing is that the child will continue to suffer from the same traumatic or burning sensations continuously. But the nerve will mostly heal in the same way, and the effect of tissue weight on the nerve’s stability cannot be overlooked in its health condition. In fact, it is not possible to fully recover from the extra weight, but the role of physical therapy or neurosurgery to remove the tissue can give more flow of movements.

3-Neural rupture

In cases of rupture, the nerves remain expanding and expanding until the nerve is completely torn, and thus will not be able to correct itself. The child will need a professional specialist to treat it properly in proportion to its condition.
The treating neurologist will usually stick and tie a different nerve of healthy muscles in the infant’s body. This will give the child some feeling, flexibility and arm support. However, there will be challenges for the child and the therapist to achieve further development and progress in the situation.


4-Nerve avulsion

Completely uprooting the nerve is the worst form of Erb’s palsy. In this case, the nerve is completely torn away from the spinal cord. Reprocessing, rehabilitation and tying the nerve again with the spinal cord is not an option. This can cause the arm to be completely motionless. However, some cases succeeded and some patients with spasms returned a degree of movement after the graft.

Erb’s palsy treatment:

The cases of children with a birth defect usually need a working cell consisting of more than one medical specialty. The medical team consists of physiotherapists, neurosurgeons, and orthopedic surgeons and this diverse team of specialists develop a joint treatment plan that outlines the recovery lines in coordination with them to recover

Splint for treatment of Erb’s palsy

Non-surgical treatments of Erb’s palsy:

Physiotherapy and massage therapy help improve arm and nerve strength. The rates of recovery and recovery in cases that do not need surgical interventions are high, as well as in cases that are less affected by the nerve, and of course it is not possible to overlook the important role of home care. Informing the family of the truth of what is happening in the treatment plan and the importance of each corner of it is very necessary and this treatment routine it mainly helps to develop and improve the child’s health condition.

* In some cases…..

it is possible for some children to benefit well from Botox therapy. It sends stimulation to the child’s arm, which helps to heal the nerves. The normal range of Botox therapy usually takes approximately two months.

 If you do not notice any improvement or progress in the case, then it is time to consider the surgical intervention.

Surgical treatments of Erb’s palsy:

In the most deadly and most dangerous cases, surgical intervention is not a luxury option but is necessary to save the arm’s condition. The surgical procedure cannot wait for more than six months in a child’s life (it must be done before the age of six months). The earlier the surgical intervention in the child’s life, the more effective it will be, especially if the condition requires microscopic surgical intervention.
Microscopic surgery can be held at age of 3 months.

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