Brachial Plexus Neuropathies

New York City, NY , March 11, 2021 (GLOBE NEWSWIRE) -- If your child suffered nerve damage in their shoulder, arm, hand, or finger, it could be an Erb’s Palsy injury. Learn here: COMMON BIRTH INJURIES >> The birth of a baby should be a joyous and exciting time for new parents. When an infant sustains a birth injury, however, parents are left feeling confused, scared, and worried about their child’s future. Erb’s Palsy is one of the most common types of birth injuries, occurring in about 2.6 per 1,000 births. About 10 percent of infants with Erb’s Palsy will not fully recover their mobility. With a lifelong injury like this, it’s important for parents to work with a medical malpractice lawyer to ensure they receive full and fair compensation to cover the cost of their child’s medical treatments, rehabilitation, therapy, and other damages. What Is Erb’s Palsy? Erb’s Palsy, which is named for the doctor who first described the injury, is a type of birth injury that damages the network of nerves in the neck that connect to the arm. This cluster of nerves allows a person to properly move their fingers, hand, arm, and shoulder. When these nerves are damaged, an individual typically experiences weakness and loss of mobility in all or some of these areas. In most cases, babies suffer Erb’s Palsy during a difficult delivery, often when they get stuck in the birth canal and their heads are stretched too far to one side. In some cases, infants or toddlers regain full mobility through physical therapy. In other cases, however, they have a weak or paralyzed arm throughout their life. A common sign of Erb’s Palsy is an arm that is rotated in toward the body. How Common Is Erb’s Palsy? Erb’s Palsy is actually one of the most common types of birth injuries. It can be difficult for doctors and researchers to determine how often it occurs, as some children will sustain Erb’s Palsy and then recover on their own. However, estimates put the number of cases between 0.9 and 2.6 per 1,000 births. In between. 0.4 and 5 cases out of 10,000, Erb’s Palsy causes serious arm weakness. What Causes Erb’s Palsy? Erb’s Palsy is entirely preventable, which is one of the reasons it’s so devastating when it occurs. Medical experts state that Erb’s Palsy almost always occurs during a difficult obstetrical event, including cases in which a baby is overly large or delivered breech, meaning a feet-first delivery. Erb’s Palsy can also occur when a mother’s labor is prolonged and the baby is stuck in the birth canal for too long. In some cases, a baby’s oxygen level drops, and doctors rush to forcibly remove the baby from the birth canal, causing injury to the nerves in the neck. This can happen during a forceps delivery or when the doctor uses too much force to pull the baby out of the birth canal. In many Erb’s Palsy birth injury cases, medical experts who review an infant’s case and birth state that a cesarean delivery would have prevented the birth injury. What Are the Symptoms of Erb’s Palsy? Erb’s Palsy can range from a mild case to a severe condition, depending on various factors during the birthing process. Each case is unique, which is why it’s important for parents to ensure their child is thoroughly evaluated as soon as possible. The symptoms of Erb’s Palsy can include weakness in the affected arm, a loss of feeling in the arm and shoulder, numbness and lack of feeling in the fingers, loss of mobility, and total or partial paralysis. In many cases, doctors diagnose Erb’s Palsy right away. In other cases, however, the condition isn’t discovered until the child gets older and begins independently moving their arms. It may be necessary for the infant to undergo diagnostic testing to confirm Erb’s Palsy. These tests can include MRIs, x-rays, and other types of imaging to determine the extent of injury to the nerves and muscles. As the child gets older, medical providers may also want to study nerve function, which can be done through nerve conduction studies (NCS) and electromyogram (EMG). How Is Erb’s Palsy Treated? The treatments for Erb’s Palsy can vary a great deal depending on the severity of the injury. In some cases, Erb’s Palsy will resolve without treatment. In other cases, the condition will resolve over time and with treatment, which can vary. However, in some cases, Erb’s Palsy is permanent. Medical experts note that nerves tend to heal very slowly, so it can take years for a child to fully recover function in their shoulder, arm, hand, and fingers. When doctors recommend nonsurgical treatment for Erb’s Palsy, they typically recommend that a child undergo physical therapy. In some cases, a child may need daily physical therapy to recover from the condition, particularly as they grow and start developing fine motor skills. In other cases, a child may need to undergo surgery. Medical experts state that some doctors will recommend surgical intervention if a child’s condition has not improved after six months of physical therapy and other non-invasive treatments. Surgical treatments can include the following: Nerve grafts – In some cases, doctors may decide to repair ruptures in the nerves by using a spliced nerve from a donor and grafting it onto the child’s damaged nerve. – In some cases, doctors may decide to repair ruptures in the nerves by using a spliced nerve from a donor and grafting it onto the child’s damaged nerve. Nerve transfers – In a nerve transfer surgery, doctors replace a damaged nerve with a functioning nerve from a donor. – In a nerve transfer surgery, doctors replace a damaged nerve with a functioning nerve from a donor. Release of joint contractures – Doctors may also suggest a procedure known as a release of joint contractures, which involves releasing tissue around the shoulder and elbow joints that has become thickened. – Doctors may also suggest a procedure known as a release of joint contractures, which involves releasing tissue around the shoulder and elbow joints that has become thickened. Tendon transfer – In a tendon transfer, doctors remove a tendon from one part of the child’s body and reattach it in the affected part of the shoulder. This is often done in cases where the child lacks the ability to raise their arm. One of the things that makes surgical treatments for Erb’s Palsy nerve racking for parents is that nerves typically heal quite slowly. Thus, it can take months or years for a doctor to know if the surgery was successful. Complications with Erb’s Palsy In the best case scenario, a baby with Erb’s Palsy will fully recover their mobility somewhere between six and 12 months following birth. However, this is not always the case. There are situations in which an infant’s condition never gets better or only marginally improves. If the nerves are severely traumatized during birth, scar tissue can develop, which can affect the complex network of nerves running from the neck through the arms to the fingers. When nerves are severely stretched, damaged, and torn, the child may be permanently disabled. In the most severe cases of Erb’s Palsy, a child suffers permanent paralysis and impairment. Are There Risk Factors for Erb’s Palsy? While Erb’s Palsy can happen during any labor and delivery, there are certain conditions that put a baby at higher risk of suffering a birth injury like Erb’s Palsy. Large baby – One of the most common risk factors for Erb’s Palsy is a larger than average baby. When an infant is bigger than usual, it can have a difficult time descending through the birth canal. If the shoulders get stuck, doctors may have to work quickly to remove the baby. These interventions can include a forceps delivery, which can damage the baby’s nerves. Obstetricians can usually detect the likelihood of an abnormally large baby. They can usually estimate a baby’s size in the last few weeks of pregnancy by measuring the mother’s stomach and performing ultrasounds. In addition, maternal conditions like gestational diabetes can often cause an infant to be larger than normal. In cases where a baby appears too large for a safe vaginal birth, many medical experts recommend a cesarean delivery to avoid complications like Erb’s Palsy. – One of the most common risk factors for Erb’s Palsy is a larger than average baby. When an infant is bigger than usual, it can have a difficult time descending through the birth canal. If the shoulders get stuck, doctors may have to work quickly to remove the baby. These interventions can include a forceps delivery, which can damage the baby’s nerves. Obstetricians can usually detect the likelihood of an abnormally large baby. They can usually estimate a baby’s size in the last few weeks of pregnancy by measuring the mother’s stomach and performing ultrasounds. In addition, maternal conditions like gestational diabetes can often cause an infant to be larger than normal. In cases where a baby appears too large for a safe vaginal birth, many medical experts recommend a cesarean delivery to avoid complications like Erb’s Palsy. Breech birth – A breech birth is another possible risk factor for Erb’s Palsy. In a breech birth, the baby is facing feet first rather than head down. In a normal delivery, the head should emerge first. When the baby is delivered with their feet first, this can put abnormal pressure on the baby’s shoulders and head. In addition, when the doctor must tug on the baby’s feet and legs during the birth process, this can stretch the neck and shoulders, causing injury. In many cases, obstetricians will choose to perform a scheduled cesarean delivery rather than a vaginal delivery when a baby is positioned breech in the womb. If your doctor chose to deliver your baby breech as a vaginal delivery and your baby suffered a birth injury like Erb’s Palsy as a result, you may be entitled to compensation. Types of Birth Injuries >> Erb’s Palsy Injuries in Childhood Erb’s Palsy typically happens during birth, but it can also occur in childhood and even adulthood in some circumstances. In some cases, a child can suffer an Erb’s Palsy injury during an accident, playground injury, or some other type of trauma. In addition, contact sports such as football can sometimes lead to an Erb’s Palsy injury. If your child suffered nerve damage in their shoulder, arm, hand, or finger, it could be an Erb’s Palsy injury. It’s important to seek medical treatment as soon as possible, and then discuss your case with a personal injury lawyer. Choosing the right NY birth injury lawyer When a child is injured at birth, the damages involved can span a lifetime. In a medical malpractice case, you get just one opportunity to ensure you receive the compensation you need to cover your costs throughout your child’s life. This is why it’s so important to make sure you work with an experienced New York City birth injury and medical malpractice lawyer. Your child deserves full and fair compensation for their injury, and no parent or child should have to bear the burden of another’s negligence. Sources: Check out Birth Injury Lawyer in New York Jonathan C. Reiter Law Firm >> CONTACT US ABOUT YOUR CASE Recent birth injury settlements & verdicts in NY >> See our New York Chiari Malformation Attorney Jonathan C. Reiter Announces $5 Million Verdict Featured on HuffPost >> 4 Things Children With Birth Injuries And Their Parents Should Know That Could Be Worth Lots Of Money Jonathan C. Reiter Law Firm, PLLC ## 212-736-0979 This news has been published for the above source. Jonathan C. Reiter Law Firm, PLLC [ID=16639] Disclaimer: The information does not constitute advice or an offer to buy. Any purchase made from this story is made at your own risk. Consult an expert advisor/health professional before any such purchase. Any purchase made from this link is subject to the final terms and conditions of the website's selling. The content publisher and its distribution partners do not take any responsibility directly or indirectly. If you have any complaints or copyright issues related to this article, kindly contact the company this news is about. Attachment

A study by researchers at Hospital for Special Surgery (HSS) finds that electromyography (EMG) testing to determine the quality of donor nerves can improve the outcome of nerve transfer surgery to restore function in patients with a brachial plexus injury. EMG is a sophisticated test used to objectively measure muscle and nerve function. The paper, “Does Pre-operative Donor Nerve Electromyography Predict Nerve Transfer Outcomes?,” will be presented at the annual meeting of the American Academy of Orthopaedic Surgeons on March 13 in New Orleans. “Our study found that pre-operative EMG evaluation should be considered a critical component of the donor nerve selection process when planning brachial plexus nerve transfer reconstruction,” said Scott W. Wolfe, MD, senior investigator and Director of the Center for Brachial Plexus and Traumatic Nerve Injury at Hospital for Special Surgery in New York City. The brachial plexus is a network of nerves that extends from the spinal cord in the neck, under the collarbone and down the arm. These nerves control the hand, wrist, elbow and shoulder. Injury to the brachial plexus can be devastating, and the most common cause is a serious accident or sports injury. Nerve reconstruction is considered when the nerves are so severely damaged they cannot recover on their own. These complex operations can take up to 12 hours. One way surgeons can reconstruct nerves is by performing a nerve transfer to restore function. They carefully dissect out portions, or fascicles, of nearby functioning nerves (called “donor nerves”) and transfer these fascicles to the injured nerves to restore electrical connectivity and enable nerve regeneration to the paralyzed muscle. “A nerve transfer takes a working nerve from one muscle and transfers part of that nerve to the injured, non-working nerve or another muscle, so the two muscles can share the nerve and regain function,” Dr. Wolfe explained. Electromyography is often used in the pre-operative assessment of brachial plexus injuries to estimate the degree of damage. However, the ability to predict surgical outcomes using pre-operative EMG to test donor nerves had not been previously evaluated. Researchers hypothesized that the health of the donor nerve and corresponding muscle, as assessed by EMG, could predict the outcome of nerve transfer surgery. A retrospective review was conducted to investigate outcomes of nerve transfers for elbow flexion (ability to bend one’s elbow) and shoulder abduction (ability to lift arm away from the body). Muscle strength was graded both pre-operatively and at least one-year after surgery. Pre-operative EMG results for donor nerves were classified on a scale that rated their level of function and then compared with the patient’s muscle strength and range of motion after surgery. Forty nerve transfers were identified. Twenty-seven were performed for elbow flexion and 13 for shoulder abduction. Overall, the 29 transfers using a normal donor nerve showed significantly greater post-operative improvement in muscle strength and function than the 11 transfers with the less robust donor nerve, as classified by EMG. In the shoulder patients, the use of normal donor nerves resulted in greater strength and active motion compared to less robust donor nerves. In the elbow cohort, double nerve transfers with two normal donor nerves demonstrated improved strength compared to double nerve transfers when one of the donor nerves was affected by the injury. Joseph Feinberg, MD, physiatrist-in-chief and co-medical director of the Brachial Plexus Center at HSS, has developed a system to classify potential donor nerves according to four levels of functioning: normal, moderately limited function, very limited function and no function. “Interestingly, we found that some of the donor nerves that were damaged and had some functional limitations were still healthy enough to do their job after the nerve transfer operation,” Dr. Feinberg said. “On the flip side, if electromyography shows that a potential donor nerve is not at all functional, the surgeon may want to consider a different nerve donor, or potentially another solution such as nerve grafting or muscle transfer.” “Our findings demonstrate that a semi-quantitative EMG classification describing the quality of donor nerves can predict outcome as measured by post-operative muscle strength and range of motion,” said Dr. Wolfe. “Despite the small numbers studied, we observed significantly greater gains in strength and range of motion in the normal donor nerve group as compared to the less robust donor nerves. EMG evaluation has value as a confirmatory component of the donor nerve selection process when planning brachial plexus surgery.” The Center for Brachial Plexus and Traumatic Nerve Injury at Hospital for Special Surgery offers advanced diagnostic and treatment options, including complex nerve reconstruction surgery. Only 150 to 200 highly specialized surgeons worldwide perform these reconstructive surgeries, and Dr. Wolfe and his colleagues aim to raise awareness that the procedures can restore function in people severely debilitated by a nerve injury. It is important for patients to be treated in a timely manner. Unfortunately, some patients suffer long-term impairment from nerve injuries that could have been repaired. Many people, including physicians, are unaware that nerve reconstructive surgery is an option, according to Steve K. Lee, MD, director of research at the Center for Brachial Plexus and Traumatic Nerve Injury. “When a nerve that controls a muscle loses function, it needs to be reactivated within about 12 months, before the muscle atrophies. Studies have shown that if nerve reconstruction surgery is done within six months after a nerve is damaged, patients do much better.”