Erb-Duchenne and Dejerine-Klumpke Palsies
- Article
- 2021-03-07
The brachial plexus is a network of nerves that carry signals from the spine to the shoulder, arm, and hand. Brachial plexus injuries are caused by damage to those nerves. Erb-Duchenne (Erb's) paralysis refers to paralysis of the upper brachial plexus. Dejerine-Klumpke (Klumpke's) paralysis refers to paralysis of the lower brachial plexus. While injuries can occur at any time, many brachial plexus injuries occur when a baby's shoulders are hit during delivery and the nerves of the brachial plexus stretch or tear. There are four types of injuries to the brachial plexus: avulsion, the most severe type, where the nerve is pulled from the spine; fracture, in which the nerve is torn but not at the spinal junction; neuroma, in which the nerve has been torn and healed, but scar tissue puts pressure on the injured nerve and prevents it from carrying signals to the muscles; and neuropraxia, or stretching, in which the nerve is damaged but not ruptured. Neuropraxia is the most common type of injury to the brachial plexus. Symptoms of brachial plexus injury may include a limp or paralyzed arm; lack of muscle control in the arm, hand, or wrist; and lack of sensation or feeling in the arm or hand.
Therapy
Some brachial plexus injuries can heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment of brachial plexus injuries includes physical therapy and, in some cases, surgery.
Prognosis
The location and type of brachial plexus injury determines the prognosis. With avulsion and fracture injuries, there is no possibility of recovery unless the surgical connection is performed in time. The chance of recovery varies for neuroma and neuropraxy injuries. Most people with neuropraxy injuries recover spontaneously with a 90-100 percent recovery of function.
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