21. Virtual Hospital: Brachial Plexus Palsy: A Perspective On Current Management brachial plexus palsy A Perspective on Current Management. Anatomy and Pathophysiology.brachial plexus palsy occurs in 0.1% to 0.4% of live births. http://www.vh.org/pediatric/provider/pediatrics/brachialpp/

Brachial Plexus Palsy: A Perspective on Current Management Herman A. Hein, M.D. Professor of Pediatrics University of Iowa Hospitals and Clinics First Published: Winter 2000 Last Revised: September 2003 Peer Review Status: Internally Peer Reviewed Although known to the ancients, brachial plexus palsy (BPP) first attracted significant attention toward the end of the nineteenth century. Duchenne coined the term "obstetric palsy" in 1872 in his book, Traite de L'electrisation Localisee. There he described in detail four cases of proximal root paralysis occurring after delivery. Unfortunately, the term "obstetric palsy" is still used by some, especially the Europeans, and connotes a cause and effect relationship between the events of delivery and the palsy. As I will discuss below, it is now known that this is not the case in many patients, especially, those with the poorest outcomes. In the English literature, Erb's name became attached to paralysis of the upper nerve roots through his classic description in 1874. Klumpke's name is associated with lower root paralysis and likely dates to his article in the French literature appearing in 1885. Anatomy and Pathophysiology The type of injury that occurs with stretch damage to the brachial plexus depends on where the injury takes place. Proximal lesions within the spinal canal involve the nerve rootlets and are called avulsions, with the rootlets torn from the spinal cord proximal to the formation of a mixed nerve root. Avulsed nerve rootlets do not recover their function and surgical reconnection of nerve rootlets to the spinal cord does not appear to be possible.

22. Brachial Plexus Injury/Erb's Palsy Brachial Plexus Injury/Erb s Palsy The brachial plexus palsy Foundation International.4 affiliated groups. Fundraising. WRITE brachial plexus palsy Fdn. http://my.webmd.com/hw/raising_a_family/shc29bpi.asp

var guid_source = ""; var guid_source_id = ""; //unused var encodedurl = ""; WebMD Today Home WebMD News Center Member Services WebMD University My WebMD Find a Physician Medical Info Check Symptoms Medical Library Quizzes, Calculators Clinical Trials ... Women, Men, Lifestyle Who We Are About WebMD Site Map Health Topics Symptoms ... Erb's Place Brachial Plexus Injury/Erb's Palsy The Brachial Plexus Palsy Foundation International. 4 affiliated groups. Founded 1994. Education and support for families affected by brachial plexus palsy, a condition caused by injury. Information on treatment. Newsletter, phone support, information and referral. Fundraising. WRITE: Brachial Plexus Palsy Fdn. 210 Springhaven Circle Royersford, PA 19468 CALL: 610-792-4234 FAX: 610-948-0678 E-MAIL: brachial@aol.com WEBSITE: http://www.membrane.com/bpp VERIFIED: 3/11/2003 Erb's Place Online. Provides support and information for persons affected by Erb's palsy (aka brachial plexus injury). Live chat on Monday evenings. Message board, listserv, family matching. Information on local groups. Provides assistance starting local groups. WRITE: National Brachial Plexus/Erb's Palsy Assn., Inc.

23. Erb's Palsy Upper brachial plexus palsy, ErbDuchenne Type. Disorder SubdivisionsNone. General Discussion Erb s Palsy is caused by an injury http://my.webmd.com/hw/raising_a_family/nord738.asp

var guid_source = ""; var guid_source_id = ""; //unused var encodedurl = ""; WebMD Today Home WebMD News Center Member Services WebMD University My WebMD Find a Physician Medical Info Check Symptoms Medical Library Quizzes, Calculators Clinical Trials ... Women, Men, Lifestyle Who We Are About WebMD Site Map Health Topics Symptoms ... For a Complete Report Erb's Palsy Important It is possible that the main title of the report Erb's Palsy is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. Synonyms Erb-Duchenne Palsy Erb's Paralysis Erb-Duchenne Paralysis Duchenne-Erb Paralysis Duchenne's Paralysis Duchenne-Erb Syndrome Upper Brachial Plexus Paralysis, Erb-Duchenne Type Upper Brachial Plexus Palsy, Erb-Duchenne Type Disorder Subdivisions None General Discussion Erb's Palsy is caused by an injury to one or more nerves that control and supply the muscles of the shoulder and upper extremities (upper brachial plexus). It is usually seen in newborns and occurs as a result of a difficult delivery. Resources NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases 1 AMS Circle Bethesda, MD 20892-3675

24. Care And Treatment For Brachial Plexus Palsy. brachial plexus palsy is caused by a birth injury to the brachial plexus,the nerve network that controls movement and sensation of the arm. http://www.stlouischildrens.org/articles/kids_parents.asp?ID=196

25. Birth Injury Lawyers: Brachial Plexus Palsy Birth defect lawyers and medical malpractice attorneys handling brachial PlexusPalsy cases, erbs palsy, cerebral palsy cases, medical negligence cases and http://www.personal-injury.com/practice_areas.asp?ID=127&Practice=Brachial_Plexu

26. IRSC - Rare Disorders, Brachial Plexus Palsy Rare Disorders brachial plexus palsy. IRSC Home Rare Disorders Brachial PlexusPalsy. Categories. National Brachial Plexus/Erb s Palsy Association, Inc. http://www.irsc.org:8080/irsc/irscmain.nsf/sub?readform&cat=Rare Disorders&subca

27. IRSC - Rare Disorders, Brachial Plexus Palsy Rare Disorders brachial plexus palsy. IRSC Home Rare Disorders brachial plexus palsy. Categories. Online Community, Web Pages, http://www.irsc.org:8080/irsc/irscmain.nsf/sub?readform&cat=Rare Disorders&subca

28. Brachial Plexus Injury/Erb's Palsy Founded 1994. Education and support for families affected by brachial plexuspalsy, a condition caused by injury. The brachial plexus palsy Foundation. http://www.bchealthguide.org/kbase/shc/shc29bpi.htm

document.write(''); var hwPrint=1; var hwDocHWID="shc29bpi"; var hwDocTitle="Brachial Plexus Injury/Erb's Palsy"; var hwRank="1"; var hwSectionHWID="shc29bpi"; var hwSectionTitle=""; var hwSource="cn6.0"; var hwProdCfgSerNo="wsh_html_031_s"; var hwDocType="SHC"; Self Help Clearinghouse Brachial Plexus Injury/Erb's Palsy The Brachial Plexus Palsy Foundation International. 4 affiliated groups. Founded 1994. Education and support for families affected by brachial plexus palsy, a condition caused by injury. Information on treatment. Newsletter, phone support, information and referral. Fundraising. WRITE: Brachial Plexus Palsy Fdn. 210 Springhaven Circle Royersford, PA 19468 CALL: 610-792-4234 FAX: 610-948-0678 E-MAIL: brachial@aol.com WEBSITE: http://www.membrane.com/bpp VERIFIED: 3/11/2003 Erb's Place Online. Provides support and information for persons affected by Erb's palsy (aka brachial plexus injury). Live chat on Monday evenings. Message board, listserv, family matching. Information on local groups. Provides assistance starting local groups. WRITE: National Brachial Plexus/Erb's Palsy Assn., Inc.

29. Erb's Palsy Upper brachial plexus palsy, ErbDuchenne Type. Disorder Subdivisions. None.Related Disorders List. 784-788. brachial plexus palsy IN THE NEWBORN. http://www.bchealthguide.org/kbase/nord/nord738.htm

document.write(''); var hwPrint=1; var hwDocHWID="nord738"; var hwDocTitle="Erb's Palsy"; var hwRank="1"; var hwSectionHWID="nord738"; var hwSectionTitle=""; var hwSource="cn6.0"; var hwProdCfgSerNo="wsh_html_031_s"; var hwDocType="NORD"; National Organization for Rare Disorders, Inc. Erb's Palsy Important It is possible that the main title of the report is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. Synonyms Erb-Duchenne Palsy Erb's Paralysis Erb-Duchenne Paralysis Duchenne-Erb Paralysis Duchenne's Paralysis Duchenne-Erb Syndrome Upper Brachial Plexus Paralysis, Erb-Duchenne Type Upper Brachial Plexus Palsy, Erb-Duchenne Type Disorder Subdivisions None Related Disorders List Information on the following diseases can be found in the Related Disorders section of this report: Parsonnage-Turner Syndrome Peripheral Neuropathy General Discussion Erb's Palsy is caused by an injury to one or more nerves that control and supply the muscles of the shoulder and upper extremities (upper brachial plexus). It is usually seen in newborns and occurs as a result of a difficult delivery. Symptoms Erb's Palsy is a paralysis of the shoulder and upper extremity. It is most often seen in newborns. This disorder is characterized by an abnormal positioning (adduction) and internal turning of the shoulder with a rotation of the forearm. This rotation causes the hand to be turned downward (pronation). On the affected side there may also be paralysis of the diaphragm, a loss of feeling and a wasting of the muscles (atrophy). The wrist and hand are usually not affected by any loss of feeling or function.

30. The Hospital For Sick Children - Brachial Plexus Palsy brachial plexus palsy, You are here brachial plexus palsy. Please usethe side menu to learn about brachial plexus palsy and our program. http://www.sickkids.on.ca/plasticsurgery/section.asp?s=Brachial Plexus Palsy&sID

31. Obstetrical Brachial Plexus Palsy, Mayo Clinic In Rochester, Minn. Obstetrical brachial plexus palsy. Symptoms. Depending on the typeand severity of the brachial plexus injury, symptoms may include http://www.mayoclinic.org/brachialplexus-rst/bpobpalsy.html

Home About Mayo Clinic Contact Us Mayo Clinic Locations: Arizona Florida Minnesota Mayo Clinic ... Medical Services Brachial Plexus Brachial Plexus Treatment Obstetric Palsy Traumatic Injuries Patient Stories ... Medical Services Obstetrical Brachial Plexus Palsy Symptoms Depending on the type and severity of the brachial plexus injury, symptoms may include: A limp or paralyzed limb Lack of muscle control in the arm, hand or wrist Lack of feeling or sensation in the arm or hand Evaluation The diagnosis of an obstetrical brachial plexus injury is typically established soon after birth, but may be delayed. The initial patient evaluation should occur as early as possible. This will consist of careful clinical history and physical examination and may also include imaging and electrical studies. It still is appropriate to have the child evaluated later, as reconstructive options may still be available, although the treatment options and results in such cases are generally more limited. Patients will be evaluated sequentially throughout their childhood to monitor functional recovery. Treatment Options depend on the type and severity of the injury, and age of the child. During the recovery phase, range of motion activities and strengthening of muscles in the limb should be performed.

32. OBSTETRIC BRACHIAL PLEXUS INJURIES Orthopaedic considerations in obstetric brachial plexus palsy.”Orthop Rev 16(5) 2902. Capek, L., HM Clarke, et al. (1998). http://uscneurosurgery.com/glossary/o/obstetric_brachial_plexus_injuri.htm

33. Klumpkes Palsy Brachial Plexus Palsy Horners Syndrome Klumpkes Palsy, brachial plexus palsy, Horners Syndrome medical malpracticesettlements. brachial plexus palsy HORNERS SYNDROME. http://www.medical-malpractice.us.com/brachial_plexus_palsy.html

Medical Malpractice Laparoscopy Gynecology Cancer ... Contact BRACHIAL PLEXUS PALSY : HORNERS SYNDROME Brachial plexus palsy is caused by damage to the network of nerves that control the muscles of the shoulder, arm, elbow, wrist, hand and fingers. These injuries usually occur due to excessive force being used during delivery, often as a result of shoulder dystocia, which causes tension which may stretch or rupture nerves. Almost 3 out of every 1,000 newborn babies are affected and over 90% of these injuries are caused as a result of medical malpractice. Shoulder dystocia occurs during delivery when a baby’s shoulder becomes lodged behind the mother’s pubic bone and is an obstetric emergency with the potential to severely injure both the mother and child. If the health care professionals dealing with the delivery fail to properly manage the situation and excessive traction is placed on the baby’s head then severe nerve damage can occur. There are several well documented risk factors associated with shoulder dystocia which a properly trained obstetrician should identify. Increased risks include above average birth weight baby, obese mother and a long second stage of labor. Any mother who falls into the high risk category should be given the option of a caesarean section. The most common injuries are: Complete brachial plexus palsy which occurs when all five nerves of the brachial plexus are affected causing the entire arm to be paralysed. Brachial Plexus Palsy is often associated with Horners Syndrome and Torticollis.

34. A To Z Encyclopedia Topic: Brachial Plexus Palsy Brachial Plexus Program. Unfortunately, at this time, we are not ableto provide information about this condition or procedure. However http://web1.tch.harvard.edu/cfapps/A2ZtopicDisplay.cfm?Topic=Brachial Plexus Pal

35. Neurological Disorders, Peripheral Nervous System, Nerve Compression Syndromes, Neurological Disorders, Peripheral Nervous System, Nerve Compression Syndromes, BrachialPlexus Palsy. Submit Your Site to the brachial plexus palsy category. http://www.iseekhealth.com/brachial_plexus_palsy-2112.php

Home About Us Contact Submit Your Site Search : Home Health Conditions and Diseases Neurological Disorders ... Brachial Plexus Palsy More Brachial Plexus Palsy Categories: Submit Your Site to the Brachial Plexus Palsy category Sponsored Brachial Plexus Palsy Sites Epilepsy Book Store At WellnessBooks.com Comprehensive source to books on Epilepsy. Includes community boards and chat, book reviews and online ordering. Neurological Disorders Due To An Imbalance? Do you have a neurological disorder? This may be due to an imbalance. Check the balance of your system and get natural recommendations for restoring balance. Brachial Plexus Birth Injuries - Information sheet compiled by NINDS, the National Institute of Neurological Disorders and Stroke. Brachial Plexus Injuries - Information sheet compiled by NINDS, the National Institute of Neurological Disorders and Stroke. Brachial Plexus Injury / Erb's Palsy - Information about the condition and of surgical procedure to treat it. Brachial Plexus Palsy Clinic - Information about brachial plexus palsy for parents, physicians, therapists and nurses. From St Louis Children's Hospital, Washington University Medical School.

36. Brachial Plexus Surgery - Texas Children's Hospital - children. The National Health Conference on brachial plexus palsy, 1997. palsy.The National Health Conference on brachial plexus palsy, 1997. http://www.texaschildrenshospital.org/carecenters/BrachialPlexus/PubList.aspx

search ALL or a topic Medical Staff News Center HOME ABOUT TEXAS CHILDREN'S PATIENT CARE CENTERS FIND A DOCTOR ... Neighborhood Services BRACHIAL PLEXUS PROGRAM Publications and links See also Brachial plexus home Clinic overview Surgery - what to expect Understanding brachial plexus injury ... Treatment goals Publications and links Brachial plexus brochure Guide to brachial plexus surgery Video news release Additional links Erb's Palsy Organization Publications Laurent JP, Lee R, Shenaq SM, Parke JT, Solis IS, Kowalik L. Neurosurgical correction of upper brachial plexus birth injuries . Journal of Neurosurgery 79: 197-203, 1993. Laurent JP, Lee R. Birth-related upper brachial plexus injuries in infants: Operative and non-operative approaches . Journal of Child Neurology 9: 111-117, 1994.

37. Brachial Plexus Palsy: Concepts Of Causation For Parents brachial plexus palsy Concepts of Causation For Parents. James O Leary,MD*. Following birth parents frequently ask how did this http://www.injurednewborn.com/oleary.html

Brachial Plexus Palsy: Concepts of Causation For Parents James O'Leary, M.D.* Following birth parents frequently ask how did this Brachial Plexus Injury (BPI) occur? Introduction In the past, obstetric textbooks have quoted reliable scientific research demonstrating that traction causes stretching of the brachial plexus nerves. Engineering studies when properly designed confirm traction forces: improper scientific designs have not. There are several articles in the recent literature espousing the view that perhaps shoulder dystocia is not particularly important in the pathogenesis of Erbs palsy. Some have catchy, if not sophomoric titles, implying that Erbs palsy is as likely to occur with normal vaginal delivery or with cesarean section as with deliveries associated with shoulder dystocia. A critical look at these articles shows that the vast majority of Erbs palsy in patients with shoulder dystocia are caused by the care provider to a probability of 95 to 98%. Erbs palsy in the absence of shoulder dystocia is a very rare event, and shoulder dystocia itself is a risk factor for Erbs palsy at a 50-200X level. It is clear that in any particular case with shoulder dystocia, the likelihood that it was unrelated to the shoulder dystocia, but rather was caused by intrauterine events approaches zero. In sum, these 'cutely titled" articles show that traumatic cesarean section deliveries have, according to the literature, been associated with Erbs palsy about once every ten years. These articles prove, if they prove anything, how small a percentage of Erbs palsy can be attributed to intrauterine events, and not that this intrauterine cause of Erbs palsy is frequent, or of high enough probability to have medicolegal significance.

38. Rochester-info.com, Medical, Erb's Palsy (Brachial Plexus And Shoulder Dystocia) The Brachial Plexus Clinic is a multispecialty clinic for the evaluationand treatment of patients with obstetrical brachial plexus palsy. http://www.rochester-info.com/erbspalsy.htm

Rochester-info.com Sponsored by Max Lent Communications Web Consulting © Max Lent 2004 Add this page to your favorites 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

39. Brachial Plexus Injury/Erb's Palsy The brachial plexus palsy Foundation. Founded 1994.Education and support forfamilies affected by brachial plexus palsy, a condition caused by injury. http://www.meritcare.com/hwdb/showTopic.asp?pd_hwid=shc29bpi

40. Klumpkes Palsy Brachial Plexus Palsy Erbs Palsy Klumpkes Palsy, brachial plexus palsy, Erbs Palsy solicitors compensation claims.Medical Negligence. Legal Aid. KLUMPKES PALSY brachial plexus palsy ERBS PALSY. http://www.hospitalnegligence.co.uk/brachial_plexus_birth_injury.html

Medical Negligence Legal Aid No Win No Fee Compensation Claims ... Cosmetic Surgery CONTACT FORM Name Address 1 Address 2 Address 3 Home Tel Work Tel Mobile Tel Email Negligence Date Negligence Details Injury Data Protection KLUMPKES PALSY BRACHIAL PLEXUS PALSY ERBS PALSY Brachial plexus palsy is caused by damage to the network of nerves that run from the spinal cord across the shoulder and down the arms to the tips of the fingers. Injury to the nerves of the brachial plexus which control the muscles of the shoulder, arm, elbow, wrist, hand and fingers can result in full to partial paralysis of one or both arms. Possible symptoms of a brachial plexus injury include a limp or paralyzed arm, and lack of muscle control in the arm or hand. The three most common brachial plexus injuries are: Klumpke's Palsy which is a paralysis of the seventh and eighth cervical and first thoracic nerves. Characteristic signs are that the hand is limp and the fingers do not move. There is often an associated Horners syndrome which is when the eyelid droops, the cheek does not sweat and the pupil is smaller than the unaffected eye. Complete Brachial Plexus Palsy occurs when all five nerves of the brachial plexus are affected. The entire arm is paralysed and there is often an associated Horner's Syndrome. Sensory loss in the arm is present and there may also be present Torticollis which is when the baby faces toward his good side and is unable to face forward for any length of time.

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