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Children who have suffered brachial plexus injuries during birth can present with differing degrees of Erb's Palsy. This is because it depends upon which nerves in the brachial plexus have been damaged and particularly whether such nerves were torn or simply bruised.

Due to the differing severity of Erb's Palsy, Erb's Palsy injury is defined into 4 different categories, the least severe being Group 1 and the most severe being Group 4. These categories are defined as follows:-

  1. Group 1 - this entails damage to the 5th and 6th cervical nerves resulting in paralysis of the shoulder muscles and elbow flexors at birth but with the hand being fine. In a large number of cases, full spontaneous recovery occurs with time.
  2. Group 2 - this entails damage to the 5th, 6th and 7th cervical nerves resulting in paralysis of the shoulder, elbow and wrist extensors at birth. The chance of full spontaneous recovery is moderate - approximately 60%.
  3. Group 3 - the whole of the brachial plexus is damaged resulting in complete paralysis of the arm and shoulder with only 30-40% recovery rate.
  4. Group 4 - this is the most serious Erb's Palsy injury where the nerves have been severed and the corresponding eye to brachial plexus is affected causing the eyelid to droop. There is no spontaneous recovery.

 

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