Symptoms of Palsy Caused by Birth Trauma

Despite all the advances in medical technology that have been made in recent decades, it’s still far too common for mistakes to be made around the time of birth that cause serious harm to the child. It’s estimated that approximately 6-8 out of every 1,000 infants born in the United States are born with a birth injury. Birth injuries can take many different forms, including different types of palsies.

Cerebral Palsy

Cerebral palsy is a condition that impacts the motor cortex, which is the part of the brain that controls movement, coordination, and muscle control. It’s important to note that cerebral palsy can take different forms and there are a few different types of cerebral palsy a person can have: athetoid, spastic, ataxic, and mixed.

Some common symptoms of cerebral palsy include:

• Muscle tremors or spasms

• Delayed developmental milestones, such as walking, crawling, or speaking

• Seizures

• Abnormal muscle tone

• Problems involving the mouth and throat, such as excessive drooling or difficulty sucking, eating, or swallowing

• Difficulties with fine motor skills

• Poor coordination

• Walking with an unusual gait

• Favoring one side of the body over the other

• Unusual reflexes

Symptoms of cerebral palsy can vary depending on the type of cerebral palsy a person has. A person with cerebral palsy might also experience other health issues such as epilepsy, vision impairments, or intellectual disabilities.

Cerebral palsy has been linked to many different potential causes. In some cases, it can be caused by circumstances beyond anyone’s control, but it can also potentially be caused by medical negligence, injuries, and other complications around the time of birth. Birth asphyxia, umbilical cord problems, failing to diagnose maternal infections, and brain trauma have all been linked to cerebral palsy. If jaundice goes untreated, that can also increase the odds of a child developing cerebral palsy.

The effects of cerebral palsy can range significantly depending on severity. One person may experience some tremors but be able to live independently while another person might be unable to walk and require constant care throughout their life. While there is no cure for cerebral palsy, medical treatments and therapy may be able to help manage the condition and improve a person’s quality of life.

Erb’s Palsy

Erb’s palsy is a type of injury to the brachial plexus, which is a network of nerves that controls movement and sensation in shoulders, arms, hands, wrists, and fingers. In cases of Erb’s palsy, injury is caused to the upper nerves of the brachial plexus, making it difficult for a person to move the shoulder and upper arm, although they may still be able to move their hand and fingers.

According to the American Academy of Orthopaedic Surgeons, Erb’s palsy impacts about 1-2 out of every 1,000 babies. Very often, it occurs during difficult deliveries when the child’s neck and shoulders are pulled in different directions, such as if shoulder dystocia occurs or during breech deliveries.

Symptoms of Erb’s palsy include:

• Pain

• Arm numbness

• Immobile arm/shoulder

• Weak grip

• An arm bent toward the body

• Weak/absent reflexes

• “Waiter’s tip” posture (An arm hanging limply at a person’s side with their hand facing outward with their fingers at a 90 degree angle)

Erb’s palsy involves four different types of nerve injuries. A child with Erb’s palsy might have one type of these injuries or they could have all four types at the same time.

Neuropraxia: The mildest and most common type of nerve injury, occurring when a nerve is stretched, but not enough to tear or cause damage. In this case, there may be some discomfort but the condition generally corrects on its own within a few months.

Neuroma: Neuroma occurs when a nerve is stretched, but stretched severely enough for the nerve to form scar tissue to form as it heals. Since the weight of the scar tissue put pressure on the rest of the nerve, neuroma only results in a partial recovery and surgery or additional physical therapy may be needed to help improve motion in the arm.

Rupture: Rupture occurs when a nerve tears rather than stretches. This kind of injury can’t heal on its own and surgery will be needed to help repair the damage. Often, surgery to treat a rupture involves grafting or transfering an uninjured nerve from elsewhere in the body.

Avulsion: Avulsions are the most severe type of nerve injury, which occur when the nerve is completely torn away from the spinal cord. The nerve cannot be surgically reattached to the spinal cord, but grafting a nerve from another area of the body can help restore some movement to the area.

In cases of Erb’s palsy that don’t require surgery, physical therapy helps with the healing process and regaining a range of motion. A person with a more severe case of Erb’s palsy may still experience weakness or a loss of motion even after undergoing surgery and occupational therapy may be recommended to help with that.

Klumpke’s Palsy

Klumpke’s palsy is another type of brachial plexus injury that results in a loss of mobility and/or sensation in the forearm and hand. It’s similar to Erb’s palsy, but the key difference between Klumpke’s palsy and Erb’s palsy are the nerves that are impacted. Erb’s palsy impacts the upper nerves in the brachial plexus while Klumpke’s palsy impacts the lower nerves.

Since the two injuries involve different nerves, the effects can show in different parts of the arm. Klumpke’s palsy can impact the hand, wrist, and fingers while Erb’s palsy impacts the upper arm, shoulder, and occasionally the forearm.

Klumpke’s palsy often occurs during complicated deliveries where the head and shoulders are pulled in different directions, such as in cases of shoulder dystocia, if the child’s head is too large for the mother’s pelvis, or if the child is in a breech position. It’s estimated that about 200,000 people in the United States are affected by Klumpke’s palsy.

Symptoms of Klumpke’s palsy include:

• Lack of sensation in the hand or forearm

• Pain

• Hand in a claw-like shape

• Inability to move the hand, forearm, or wrist

In some cases, children impacted by Klumpke’s palsy may also have Horner’s Syndrome, resulting in a drooping eyelid.

Like Erb’s palsy, Klumpke’s palsy involves four different types of injuries to the nerves: neuropraxia, neuroma, rupture, and avulsion. Depending on the exact nature of an injury involved, surgery may be required to help improve movement and sensation in the impacted area.

If your child was injured around the time of birth, it’s extremely important to speak to a birth injury attorney as soon as possible, especially if any of the following has happened:

• A doctor mentioned a loss of oxygen during delivery

• The child needed to stay behind in the hospital for additional treatment after the mother was released

• The birth was premature or required an emergency C-section

• The child was accepted to or enrolled in Michigan’s Early On program

The tragic reality of many birth trauma cases is that they very often could have been prevented. At Goodwin & Scieszka, our attorneys are ready to help answer your questions and figure out which steps to take next so that your child can get the care they need. Contact us today to get started.