The brachial plexus is a network of nerves between the neck and shoulders. These nerves provide feeling and muscle control in the shoulder, arm, hand and fingers. If stretched, compressed or torn, brachial plexus injuries can occur.

Brachial plexus injuries can occur in patients of all ages, including infants. Difficult deliveries may stretch, compress or even tear the brachial plexus nerves. These injuries may affect all or part of the brachial plexus.

There are different types of brachial plexus injuries. They are often categorized according to the type of nerve injury. Brachial plexus birth palsy is also called Erb’s palsy.

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What are the signs and symptoms of an infant brachial plexus injury??

  • Full or partial lack of movement
  • Muscle weakness or paralysis in the affected area
  • Decreased movement or sensation in the affected area
  • An odd position of the affected limb (e.g., arm hanging limp)

What causes infant brachial plexus injuries?

Several things can cause infant brachial plexus injuries, including:

  • Breech delivery
  • Large gestational size
  • Pregnancy with twins or multiples
  • Prolonged or difficult labor
  • Vacuum- or forceps-assisted delivery

How is an infant brachial plexus injury diagnosed?

  • Physical exam
  • Imaging if necessary
    • X-rays
    • Ultrasound
    • Magnetic resonance imaging (MRI)
  • Additional testing if necessary
    • Electromyogram (EMG)
    • Nerve conduction study (NCS)

How is an infant brachial plexus injury treated?

Many newborns with brachial plexus injuries at birth recover on their own. Your infant’s doctor will routinely re-examine them to check on nerve recovery. (It can take up to two years for complete recovery.)

If the injury is more complicated or does not resolve on its own, other treatment may be necessary. Treatment depends on the type and extent of your child’s injury. There are several surgical and non-surgical options to treat brachial plexus injuries:

  • Daily physical therapy
  • Range-of-motion exercises
  • Microsurgery (e.g., nerve graft or nerve transfer)
  • Release of joint contracture
  • Tendon transfer