Brachial Plexus Palsy
During a difficult childbirth, newborns are at risk for damaging nerves connecting the spine to the entire length of the arm, from shoulder to hand, resulting in partial or full paralysis of the arm in the baby. When the brachial plexus is stretched or torn the individual suffers compromised function and control of arm and hand muscles in addition to the potential for partial or complete paralysis of the area. Although these injuries may result from football tackles, vehicle accidents or other nerve trauma, a difficult birth is frequently the origin of this injury. As the baby’s shoulder is pressed downward and the head is pulled away from the shoulder during delivery when the baby is in breech position or the shoulders are too wide to adequately fit through the birth canal and get stuck, there is the potential to stretch or tear nerves.The extent of subsequent injury to the brachial plexus during such an event is dependent upon the location of the nerves affected and how significant the tear is. Generally only one arm is affected with this condition and minor injuries may heal without medical intervention. However, as the severity increases the likelihood of permanent trauma rises as is the case when the nerve is fully separated from the spinal column. Newborns demonstrating symptoms of brachial plexus palsy following birth require prompt evaluation to minimize long-term complications. Symptoms include isolated use of fingers but not upper arm muscles, arm function without the ability to use fingers or complete numbness along the length of the arm. Complications from injuries sustained during childbirth can adversely affect a baby’s optimal physical development. These complications include pain, numbness, weakening of muscles and stiffness in movement. Furthermore, the potential for permanent disability exists with this condition and may result in paralysis.
Diagnostic tools for this condition examine the strength and frequency of nerve impulses wtih MRIs and CT myelography providing detailed images of the body’s region to evaluate the extent and severity of damage. Treatment varies according to the individual patient’s medical history and diagnosis, with surgery an option to consider. Babies who do not show significant improvement in the first six months of life are recommended to have surgery to repair the nerves as it provides the best chance to recover full function of the arm, shoulder and hand muscles. Surgery typically involves transferring less important nerves and muscles from other areas of the body to the arm and spine, and ideally is performed within three to six months of injury to prevent further muscle deterioration.
Parents who suspect their child’s injury was preventable and is due to negligence on the part of the healthcare professional providing prenatal care and performing or assisting in childbirth may have the ability to pursue legal action against the provider. Preventable acts include failing to accurately evaluate baby’s size and potential complications with the baby being able to move through the birth canal.