Brachial plexus injury is a birth injury in which there is weakness or lack of movement of the arm. Brachial plexus is the network of nerves in the neck that control the arm, fingers, forearm, shoulder and hands. Mild form of brachial plexus injury can be cured but in severe cases surgery may be required and there is a possibility for lifelong damage.
What Is Brachial Plexus Injury?
The brachial plexus is a network of nerves that controls the movements and sensations of the arm, hand and shoulder from the spine. This injury occurs when the nerves in brachial plexus are stretched, torn or compressed. In infants, it usually occurs because of damage done to the brachial plexus during birth. Adults can be affected when the head is pushed away from the shoulder and the shoulder is forcefully pressed down.
Brachial Plexus Injury Causes
The network of nerves in the brachial plexus can be damaged in a difficult and long delivery. This injury is typically caused by extraction methods. This injury usually happens when the baby is pulled from the birth canal during a difficult birth.
Possible causes of injury include:
- In a feet-first delivery there may be pressure on baby’s raised arms
- In head-first delivery a baby’s shoulders may be pulled
- When the shoulder passes through the birth canal the baby’s head and neck may be pulled on one side
- Paralysis in upper or lower arm or Erb’s paralysis
- These injuries only affect lower and upper arms
- Klumpke’s palsy
There are certain factors that may increase the risk for brachial plexus injury. Such factors may include a heavy birth weight. There can also be difficulty in passing the shoulder through the birth canal after the head has come out. Another possible risk could be a breech delivery.
Brachial Plexus Injury Symptoms
Symptoms of brachial plexus injury may vary, depending upon the severity of the condition. Symptoms may appear right after birth or a few hours after birth. Doctors should detect possible brachial plexus injuries shortly after delivery.
Typical symptoms of brachial plexus injury include:
- Lack of grip on the affected side
- Lack of movement in the upper arm or lower arm of the newborn baby
- Absence of a Moro reflex on the affected side
- A possible irregular bend at the elbow
Tests for Brachial Plexus Injury
Usually, doctors will perform a physical examination in which they examine the movement of the upper and lower arm and hand. There is a likelihood that the affected arm may be limp when the infant is rolled from one side to another. When there is a nerve injury or brachial plexus injury, the Moro reflex is absent. The physical examination may also include the examination of the collarbone for fracture. Usually, X-ray imaging is used to detect a collarbone fracture.
Some brachial plexus injuries can heal without any problems. However, due to the damage to the network of nerves, some complications may arise. Complications may be temporary but sometimes, they can also persist throughout the life of the patient.
Some of the possible complications include:
- Muscle breakdown or muscle atrophy
- Loss of feeling or sensation to the affected area
- Chronic pain as a result of nerve damage
- Stiff joints
Brachial Plexus Injury Treatment
Treatment options depend on the severity of the case. Some injuries heal on their own while others may require treatment. Physicians may recommend physical therapy in order to make sure that joint and muscles are working properly. This may also prevent stiff joints. If the damage does not improve in the first few weeks, surgery is usually performed within three to six months. Surgical repair is often required for cases where the nerve has been cut or torn or there is scar tissue surrounding the nerves.
Brachial Plexus Legal Considerations
Brachial plexus injury may result in permanent damage. This type of birth injury could have been caused by the negligence of the physician or by medical malpractice. If your child has suffered from a brachial plexus birth injury or continues to suffer complications from the injury , it is necessary to speak with a qualified birth injury attorney. He or she will provide appropriate legal counsel and outline the proper steps for seeking legal recourse.
“Brachial Plexus Injury in Newborns.” MedlinePlus Medical Encyclopedia. U.S. National Library of Medicine. Web. 3 Feb. 2015. <http://www.nlm.nih.gov/medlineplus/ency/article/001395.htm>.
“NINDS Brachial Plexus Injuries Information Page.” Brachial Plexus Injuries Information Page. National Institute of Neurological Disorders and Stroke. Web. 3 Feb. 2015. <http://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm>.
“Brachial Plexus Injury.” Brachial Plexus Injury Definition. The Mayo Clinic. Web. 3 Feb. 2015. <http://www.mayoclinic.org/diseases-conditions/brachial-plexus-injury/basics/definition/con-20028265>.