Duchenne-Erb paralysis

Duchenne-Erb Paralysis is a form of brachial plexus palsy that primarily affects the upper arm. It is named after the French neurologist Guillaume Duchenne and the German neurologist Wilhelm Heinrich Erb, who first described the condition in the 19th century. This condition is characterized by weakness or paralysis of the muscles in the shoulder and upper arm, resulting from an injury to the upper trunk of the brachial plexus, a network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand.

Causes

Duchenne-Erb Paralysis typically results from trauma during childbirth, particularly in cases of shoulder dystocia, where the baby's shoulder becomes lodged behind the mother's pelvic bone. However, it can also occur due to trauma in adults, such as from a fall or a motor vehicle accident, leading to excessive stretching or tearing of the brachial plexus nerves.

Symptoms

The hallmark symptom of Duchenne-Erb Paralysis is the inability to actively raise the arm at the shoulder or flex the elbow, often leading to a characteristic posture known as the "waiter's tip" position. The arm may hang by the side with the forearm turned inward. Sensory loss in the affected arm can also occur, depending on the severity of the nerve damage.

Diagnosis

Diagnosis of Duchenne-Erb Paralysis involves a thorough physical examination and medical history. Imaging tests such as MRI (Magnetic Resonance Imaging) and ultrasound may be used to assess the extent of the nerve injury. Electromyography (EMG) and nerve conduction studies can also help evaluate the electrical activity of the muscles and the speed of nerve signal transmission, respectively.

Treatment

Treatment options for Duchenne-Erb Paralysis vary based on the severity of the condition. In mild cases, physical therapy aimed at strengthening the affected muscles and maintaining range of motion may be sufficient. Occupational therapy can also help individuals adapt to any limitations. For more severe cases, surgical interventions such as nerve grafts or transfers may be necessary to restore function. Early intervention is crucial to optimize outcomes.

Prognosis

The prognosis for individuals with Duchenne-Erb Paralysis depends on the severity of the nerve damage and the timing of treatment. Many infants with birth-related brachial plexus injuries show significant improvement within the first year of life, especially with early physical therapy. Adults with traumatic injuries may have a more variable outcome, and complete recovery is less certain.

See Also

• Brachial Plexus Injury
• Neurology
• Physical Therapy
• Occupational Therapy