Erb’s Palsy and Klumpke’s Paralysis
Erb’s Palsy is almost always unilateral and weakness is noted shortly after birth.
The following are seen on physical examination of the newborn:
– the shoulder is adducted and internally rotated
- the elbow is extended
- the forearm is pronated
- wrist is occasionally flexed
- the Moro reflex is absent on the affected side
- grasp reflex is present
- biceps reflex is diminished
Erb’s palsy is due to the trauma of the upper plexus and root of the peripheral nerves. This is commonly seen in difficult vaginal deliveries.
It has been claimed to have good prognosis however in some cases it is not. If improvement is not seen in 6 months, surgical exploration for nerve repair should be considered.
Klumpke’s Paralysis is an uncommon brachial plexus injury. It involves the intrinsic muscles of the hands with weakness of the wrist and finger flexors.
So, the patient’s grasp reflex is absent and a one sided Horner syndrome maybe seen. The prognosis of this injury is much poorer as compared
to that of Erb’s paralysis.