Erb's Palsy (Brachial Plexus and Shoulder Dystocia)
Introduction
A professional colleague and friend's wife gave birth to a baby who was damaged during birth. The shoulder of the baby was caught on part of the pelvis as it was passing through the birth canal. The result was that the baby could not move one of its arms. This Web page lists resources that may be useful to parents of children who experience the same problem which is called Erb's palsy or shoulder dystocia. If you know of additional resources that should be listed here, please send them to Max Lent.
Links
Advice
- Information for Parents of a Newborn with weak or paralyzed arm. From United Brachial Plexus Network.
- Your Newborn Baby Has A BPI, What Do You Do Next ? From Maia's site.
Art, medical and legal
- Medical and art related to brachial plexus injuries.
Articles
- Brachial Plexus/Erb's Palsy Information Links - Part I.
- Suvi's Page. An excellent list of abstracted articles.
Bulletin Boards
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Family and Personal Web sites related to brachial plexus
- Beth Israel Medical Center, Singer Division, New York, NY. The Hyman-Newman Institute for Neurology and Neurosurgery. The Center for Functional Restoration.
- Children’s Healthcare of Atlanta. "The Neurology Clinic at Children’s at Scottish Rite offers initial diagnosis for any child, from birth to age 21, for evaluation of a possible neurological disorder. Treatment and follow-up services are provided for those children who have been diagnosed..."
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Children's Hospital of Pittsburgh. "The Center for Brachial Plexus and Peripheral Nerve Injuries provides multidisciplinary evaluation and treatment of children with all types of brachial plexus and peripheral nerve injuries. Members of the center’s multidisciplinary team include specialists in neurosurgery, micro/hand surgery, neurology, physical and occupational therapy, neuroradiology and clinical social work. Team members are available during the patient’s appointment to maximize the efficiency of the patient’s evaluation and to facilitate collaboration of the different specialists. Patients with injuries to the brachial plexus and peripheral nerves benefit from this approach by receiving comprehensive medical, surgical and psychosocial information throughout their ongoing evaluation."
- Department of Neurological Surgery at Children's Hospital of Pittsburgh.
- Children's Mercy Hospital. Use their Web site search engine and key in the word brachial.
- Gillette Children's Specialty Healthcare.
- John's Hopkins Medicine.
- Lucile Packard Children's Hospital. "Pediatric Neurosurgery at Lucile Packard Children's Hospital treats infants and children with disorders affecting the central and peripheral nervous system."
- Medical College of Georgia. "Parents and physicians who have questions regarding the care of the infant with Brachial Plexus are encouraged to contact the Brachial Plexus team at 706-721-5568 or e-mail at ."
- Medical College of Wisconsin. Brachial Plexus Clinic. "The Brachial Plexus Clinic is a multi-specialty clinic for the evaluation and treatment of patients with obstetrical brachial plexus palsy.
The majority of patients with this diagnosis may improve with therapy intervention and monitoring by specialists for spontaneous recovery. For those patients with more serious injuries, surgery may be necessary to improve function. Ideally this surgery must be performed before the child reaches one year of age. Reconstructive surgery may be considered as a later option."
- The Methodist Hospital, The Neurosurgery Center. "Today, the service is recognized worldwide for the excellent patient care it provides and for comprehensive research programs, particularly in the areas of severe head trauma and ruptured aneurysms.
The service offers the full range of modern neurosurgical techniques. The sophisticated imaging facilities available at The Methodist Hospital, including CT, MR, and SPECT scanning, MR angiography, cerebral angiography with three-dimensional reconstruction greatly assist physicians in their pre-operative diagnosis, surgical planning and follow-up."
- Miami Children's Hospital, Pediatric Upper Extremity Program. "Miami Children's Hospital, through its multidisciplinary Pediatric Upper Extremity Program, provides comprehensive care and rehabilitation for infants, children and young adults with congenital and acquired disorders of the upper limb."
- New York University Medical Center, NYU Division of Pediatric Neurosurgery. "The NYU Division of Pediatric Neurosurgery is one of the leading referral centers for the surgical treatment of infants , children, and adolescents with neurological problems. Based at New York University Medical Center, a major academic medical center on Manhattan's East Side, the Division offers comprehensive care for children with brain and spinal tumors, hydrocephalus, spina bifida, epilepsy, cerebrovascular disorders, Chiari malformations, tethered spinal cord, head injury, cerebral palsy/spasticity, peripheral nerve/brachial plexus disorders, craniofacial syndromes/craniosynostosis, and spinal conditions."
- St. Louis Children's Hospital, Brachial Plexus Palsy Center. "Since 1991, our Brachial Plexus Palsy Center at the St. Louis Children's Hospital has evaluated and treated more than 200 children with birth brachial plexus injury. At our multidisciplinary Center, children are examined by a team of pediatric neurosurgeons, neurologists, and therapists. An orthopaedic surgeon specializing in hand surgery and a pediatric neurologist also work with children who have persistent muscle weakness."
- Texas Children's Hospital. Texas Children's Brachial Plexus Center. "In our experience, obstetric injuries to the brachial plexus usually cause significant functional deficits if not managed correctly. It is essential to seek evaluation by physicians experienced in the treatment of children with these injuries in order to optimize the overall outcome. It is NOT a sufficient answer for an evaluating physician to say "95% of these injuries get better" (see article in this brochure entitled "Long-term Outcome after Obstetric Brachial Plexus Injury"); it is not appropriate to deny physical therapy; it is not true that "surgery doesn't help"; and it is not "only an arm". It is a significant functional injury that often is permanently disabling, and can affect employment, health, and future socioeconomic status."
- The Yale Brachial Plexus Center. "Our close proximity to the Yale Children's Hospital allows us to combine talents with the state-of-the-art anesthetic, physical therapy and pediatric teams for diagnosis and management of brachial plexus palsy. Most often, newborns will regenerate injured nerves, and surgery is rarely necessary. If recovery is not in evidence within three months of birth, we can perform additional testing under light anesthesia as an outpatient procedure to help determine the extent of nerve and spinal cord involvement. If necessary, surgery can be safely performed as early as 3-6 months of age to repair damaged or ruptured nerves. In an older child with incomplete recovery, tendon transfers can be performed to restore balance and function to the shoulder. As a rule, children have the best regenerative capacity after brachial plexus injury because of the plasticity of their neural tissues, their boundless optimism, and their will to recover.
Legal Resources
- American Bar Association. Use to find lawyers.
- Association of Trial Lawyers of America. Use to find lawyers.
- Evidence.com. Interesting animations and commentary.
- Lawyers.com. Use to find lawyers.
- Martindale.com. A service of Lexis Nexis Martindale Hubbell
Please be very cautious of contacting the legal resources listed below. These are included here because you will probably find them elsewhere. Being listed here is not a recommendation.
- The Buckingham Law Firm. Also listed as medmal-law.com.
- Erb's-Palsy-Help.com. This Web site is sponsored by an unnamed law firm. The fact that the law firm keeps its name secret raises immediate suspicions about the firm's credibility and of the information published here. I was not able to find a law firm at this address, so beware of contacting this resource. The following is information I was able to obtain about the owner of this Web site:
Contact's email address: ( a non-working email address)
Erb's Palsy Legal Help
177 Main St., Fort Lee, NJ. 07024-6936
Fax: 419 730 5437
- Anthony Mancini & Associates. "Attorney's Representing Children Injured at Birth." "If your child or a loved one's child was injured at birth it may have been the result of medical negligence. Our Law Firm has succesfully helped children and families nationwide, who are victims of birth malpractice, secure substantial settlements and judgments, thereby providing the injured child with the resources necessary to assist with his or her special needs throughout their lives."
- Birth Injury Lawyer Network. Parker & Waichman, Attorneys and Counselors at Law. Another referral service.
Ken Sigelman, J.D., M.D., A medical doctor and a lawyer. My impression is that this site is a commercial extension of the medical malpractice side of Dr. Sigelman's business.
- Jason A. Weachter. 800-708-5433. Based on Weachter's Web site, this appears to be another referral service.
- Kathleen T. Zeller. Brachial Plexus Page. This lawyer appears to have excellent credentials.
Mailing lists
- Medical Mailbox. "Get periodic updates on many neurological conditions delivered directly to your email box for free!"
- National Brachial Plexus/Erb's Palsy Association, Inc. ""
News
- One of the best sources of delivered news on a topic is Google.com's News Alerts. Go to the URL add the key words and your email address. You will then receive by email the latest breaking stories on the topic you select. In this case the topics would include Erb's Palsy, Brachial Plexus, and so on.
Organizations
- Brachial Plexus Palsy Foundation. "Enclosed in this website is a description of a brachial plexus injury and other information to better educate families who do not have the time or resources.
Along with providing families across the world with a package of information, we also provide information on the Internet through this site. The site describes, in detail, what a brachial plexus injury is, how it is treated and what kinds of therapy are involved. We have provided information via the world wide web for people all over the world, every day."
- Gentle Birth. Shoulder Dystocia.
- injurednewborn.com. An excellent Web site with a large amount of practical information.
- National Brachial Plexus/Erb's Palsy Association, Inc.
- The National Information Center for Children and Youth with Disabilities. "NICHCY is the national information and referral center that provides information on disabilities and disability-related issues for families, educators, and other professionals. Our special focus is children and youth (birth to age 22)." New York State resources.
- National Institute of Neurological Disorders and Stroke.
- National Organization for Rare Disorders (NORD). NINDS Brachial Plexus Injuries Information Page.
- National Rehabilitation Information Center.(NARIC).
- Shoulderdystocia.com.
- United Brachial Plexus Network, Inc. "The United Brachial Plexus Network (UBPN) is a registered non-profit 501(c)3 organization devoted to providing information, support and leadership for families and those concerned with brachial plexus injuries worldwide. Available resources include: Our extensive website; Online registry, various outreach and awareness programs, and Outreach, our in-depth publication. Beginning in 2000, UBPN will also produce an annual comprehensive Resource Directory."
Other Web resource directories
- injurednewborn.com Resources.
Physicians
- Dr. Allan J. Belzberg. "Dr. Allan J. Belzberg, of the Johns Hopkins Neurosurgery Department, is one of only a handful of doctors in the country who perform brachial plexus repair operations: 'When a nerve is pulled right out of the spinal cord, we have to use a new piece of nerve that's still working, so we take the nerve from somewhere else around your neck that's still working and we make that nerve do something new.'"
- John A. I. Grossman, M.D., F.A.C.S. "Our medical staff has extensive experience in diagnosing and treating hand and nerve disorders and injuries. Here you will find information on our staff credentials and education."
- David G. Kline, M.D. "LSU Neurosurgery."
- Julia K. Terzis, M.D., Ph,D. Dr. Terzis "is recognized worldwide for her contributions to the field of Restorative Microsurgery and treatment of peripheral nerve paralysis."
Publications
Newsletter
- Outreach. "The Outreach publication is produced and distributed by UBPN roughly twice per year depending on news and need. UBPN has recently supplemented this full, magazine-style publication with "Outreach In Brief": a short newsletter (without feature articles) focusing primarily on current news and upcoming events of note."
- Special Child.
Poems and Writings
- National Brachial Plexus/Erb's Palsy Association, Inc. Poems and writings.
Support groups
- Helping Hands. ", in the Greater Northwest with my friend, Julia Aten. The first two years it was just the two of us. Now, sadly enough, there are 42 families (that we know of) in our state that are affected by Brachial Plexus Palsy. There are a dozen in Oregon and much more in the surrounding areas. I am happy to share any and all information with any family within or outside of our area."
Online
- Brachial Plexus/Erb's Palsy Networking Forum.
- Brachial Support. "This group was created to offer support to parents who have children with Brachial Plexus..All is welcome here, NO matter what road that you have chose with your children. Please join us and Help our list to grow! The more people that are here the Greater the chance we can make a difference in someone else's Life!"
- Erbspalsy · Ntl Brachial Plexus/Erb's Palsy Association. Yahoo! group.
- Obstetrical Brachial Plexus Injury Chat Room. 10:00 p.m. Wednesday evenings EST. "This chatroom is specifically for anyone who has an obstetrical brachial plexus injury or who has someone in their family who has an obstetrical brachial plexus injury."
Technology
- Mayatek. "Mayatek is the only approved supplier of equipment for Threshold ESTM. Our stimulators have been used for nearly ten years to implement the Threshold Electrical Stimulation [TES] program used to counteract disuse muscle atrophy.
Over 8,000 children and adults with a wide range of disorders including cerebral palsy and spina bifida have used Threshold ES as a complement to physical therapy. Upwards of 1,000 therapists, physicians and nurses from forty-seven states and seventeen countries have completed courses in its application."
Web Ring
- Brachial Plexus/Erb's Palsy Web ring.
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