Erb's Palsy

Also known as: Erb-Duchenne palsy, brachial plexus birth palsy/damage.

What is Erb's palsy?

The brachial plexus is a group of nerves that start in the spinal cord (near the neck) and form the nerves that allow the shoulder, arm, hand and fingers to move and feel. “Palsy” means weakness. Erb’s palsy is a form of brachial nerve palsy that occurs in newborn babies which is characterized by weakness, loss of feeling and difficulty moving the affected arm.

What causes Erb's palsy? 

There are approximately four types of injury that may occur to these nerves:

  1. A stretch injury that “ shocks “ but doesn't tear the nerve (these usually heal on their own in a few months).
  2. A stretch injury that damages some parts of the nerve resulting in a scar (a neuroma).
  3. The nerves stretched until it tears (ruptures). This is a serious injury and won't heal on its own.
  4. An avulsion where the nerve is torn from the spinal cord. This too is a serious type of nerve injury.

Typically, Erb’s palsy occurs when the brachial plexus is injured or damaged during childbirth. This usually occurs with a difficult delivery such as when a large baby passes through the vaginal canal, or when force is needed to deliver the baby with a breech presentation or during a prolonged labor.

What are the symptoms of Erb's palsy?

Typical symptoms include loss of feeling, weakness or, partial or total paralysis of one arm. If the injury is to the upper nerves, the baby may not be able to move the shoulder but could move the fingers.

What are Erb's palsy care options?

Most newborns with Erb's palsy recover without treatment. In milder cases, treatment involves daily physical therapy and range of motion exercises beginning when the baby is about 3 weeks of age. If there is no improvement over 3-6 months, surgery may be of benefit to improve outcomes. 

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: November 18, 2021 03:11 PM

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Birth-related Brachial Plexus Injury

Birth-related brachial plexus palsy refers to injury of the nerves that lead from the cervical (neck) spinal cord to the arm. These nerves can be injured during a difficult delivery. The result is weakness and/or loss of sensation in the affected arm. Learn more

Brachial Plexus and Peripheral Nerve Injuries

The brachial plexus is a network of peripheral nerves that originate in the neck region and branch off to various muscles of the arm to control movement and sensation in the shoulders, arm, forearm and hand. Injuries to the brachial plexus are most commonly seen in newborns during the process of child-birth. Other causes may include motor vehicle accidents or tumors that may affect the nerves. Learn more