What is Brachial Plexus and Peripheral Nerve Injury?

Brachial Plexus

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Birth injuries are unfortunate results of difficult circumstances during labor. A peripheral nerve injury is one such result. Brachial plexus and peripheral nerve injuries are injuries compromising the nerve group the supplies the arms and hands. Considering the brachial plexus is a peripheral nerve network spanning from the neck’s cervical spinal cord to the shoulders, arm, and hand, an injury to that network can be debilitating. This network stimulates muscles along one’s upper extremities. Any damage can cause extremity numbness or paralysis. There are many ways that brachial plexus and peripheral nerve injury can occur and be detected in newborns.

Signs to Recognize Brachial Plexus and Peripheral Nerve Injury

There are minor and more severe signs that you can look out for to determine whether or not your newborn has a peripheral nerve injury. These signs can either be mild side effects or severe physical limitations.

During labor, the baby’s nerves may have been compressed or stretched. However, the after-effects from this situation don’t last long. The most common brachial plexus injury in newborns is neuropraxia, an injury type rooted in overexertion.

Neuropraxia symptoms range from having a sudden burning sensation that travels down the nerves of the arm (called stingers) to sudden weakness within the arm. Also, you may notice that your newborn has trouble gripping things tightly or simply cannot move the arm. Babies with a peripheral nerve injury will hold the affected limb by their side with the elbow straight while the hand and forearm are tucked in. In many cases, recovery from this injury is short-term, a few days, weeks or months.  

More serious brachial plexus injuries lead to complete arm weakness as well as loss of sensation. The affected part could be paralyzed as a result. The most severe brachial plexus injury, an avulsion, takes place when the nerve root is torn from the spinal cord. If a child suffers from this or another serious brachial plexus injury, your child will experience intense pain or have muscle contractions. Your newborn may also contract Horner’s syndrome, where his or her eyelid droops and the pupil becomes constricted. If you notice these signs, you need to see a medical specialist right away to establish a definite diagnosis and an immediate treatment plan.

What Causes Brachial Plexus or Peripheral Nerve Injury in Newborns

The primary cause of brachial plexus and peripheral nerve injury in infants is birth difficulty while delivering the baby’s shoulders. The baby’s nerves can be affected by compression within the mother’s womb. During a head-first delivery, the infant’s shoulders are being stretched, or its head and neck are pulling sideways as the shoulder passes through the birth canal.

During a breech delivery, where a baby is delivered feet-first, there is increasing pressure on the baby’s arms as well, which can lead to nerve damage. Birth-assistance tools such as forceps or vacuums are used because of how stressful the delivery is, standard or breech. These tools can exacerbate an injury. Even if they are not used, an injury can be caused when a doctor applies too much pressure or force on your newborn while delivering by hand. To prevent asphyxiation or any other serious complications, the doctor may pull the baby’s shoulders with excessive force. This practice can tear the brachial plexus nerves and severely injure your baby’s upper extremities.

Other causes include maternal diabetes or obesity. Excess weight can cause the compression as mentioned earlier and make it harder for the baby to come out cleanly. Infants with a high weight and large size can also complicate the delivery and are susceptible to injury.

Furthermore, if you have contractions during prolonged labor and the baby is stuck in the birth canal, the contractions can put stress on the baby’s shoulders, head, and upper neck. This pressure can lead to bruising, tearing, or even fractures.

Treatment or Surgery for Peripheral Nerve Injury

Treatment for a brachial plexus and peripheral nerve injury varies depending on the severity and location of the damage. While some infants will heal naturally or regain strength in their nervous systems through physical rehabilitation, others require surgical procedures to correct the problem.

Doctors will only opt for surgery if your newborn has yet to recover for more than three months after the injury first happened. Most babies heal during that three-month span. However, physical therapy and daily massaging of the damaged area are suggested to strengthen the affected area. Such methods develop the affected area’s muscles so that the infant can gain full use of its arm, hand, or wrist. Your baby may do range-of-motion exercises, stretching, and other activities as part of the therapy.

On the other hand, if the injury is more severe, your newborn may go through a surgical procedure known as a nerve transfer. This peripheral nerve injury treatment involves medical professionals taking a functional nerve from another muscle. Though this may not restore the affected area to full health, your infant will be able to recover and use the previously affected area without serious struggle or pain. Your child may also go through a muscle transfer or tendon transfer to correct the problem, which will take a few months for recovery.

Legal Rights Concerning Medical Malpractice

If your newborn’s brachial plexus or peripheral nerve injury has been caused by excessive force or malpractice by a medical professional, you have the legal right to file a lawsuit. You may be eligible to receive financial compensation for your child’s suffering after what can be a life-changing injury. This compensation includes medical expenses associated with your child’s injury, rehabilitation costs, or even lost wages from caring for your child.

As with any birth injury lawsuit, you’ll need to spend time researching for it to be successful. The longest part of your case is the discovery phase, where your lawyer provides evidence documenting your infant’s injury and that its cause was due to negligence. Settlements are often reached during this phase, though they can take several months.

If your infant has a brachial plexus injury caused by improper medical practices, the Safe Birth Project can assist you with information to boost your case. Get your legal case help right away!

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