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Erb's Palsy (Brachial Plexus and Shoulder Dystocia)

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Also see Pregnancy.

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 Medconsumer.info

Articles

Books

Articles

Books

Encyclopedic Information

Forums

If you join one of these support groups, please mention that you found their group through Medconsumer.info.

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  • Medconsumerinfo.  "Medconsumer.info is your starting point for searching the Web for medical information. This forum exists for you to discuss, ask questions, and answer questions about any aspect of health, healthcare industry, and any aspect of being a patient. Please take whatever advice you receive through this forum to your doctor before changing or initiating any medically-related behavior."  Yahoo! group.

Links

Advice

Art, medical and legal

Articles

Family and Personal Web sites related to brachial plexus

Hospitals that deal with brachial plexus and shoulder dystocia injuries

  • 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..."
  • 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."
  • 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 aflanner@mail.mcg.edu."
  • 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 HospitalTexas 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

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.  "The erbs@coollist electronic mailing list/listserv is an effort by the National Brachial Plexus/Erb's Palsy Association, Inc., to assist discussions and networking information about brachial plexus palsy, however we cannot accept responsibility or liability for the information given on this discussion group. It is up to the patient and/or the patient's physician to decide on which professional and/or treatment would best suit their needs."

Message Boards

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

Other Web resource directories

Photographs

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."
  • Karen Pape, MD.  
  • 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

Support groups

  • Helping Hands.  ""Helping Hands email", 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

  • BeingSick � A global community of loving people who understand what its like to be sick or care for a loved one.  "We are a community of loving supportive people who understand what its like to be sick. We live with illness, injury, disability, or care for those that do. This group is a place where you are free to be yourself. Share your frustrations about being sick, friendships, family, and just about anything! We are the family who understands when no one else does! We live your life too! You are welcome to post in HTML, colors, send links, web pages, poems, inspiration, e-cards, jokes, chat in our chat room anytime! We are non-denominational, welcoming all races, ages, religions and cultures. We know how tough life is being sick, and we care. There is support for you here anytime you need us. You are not alone."  Yahoo! group.  
  • 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

  • TASC Network.  "Our mission is to radically improve the future for children with neurologic problems. New neuroscience information proves that children have a better potential for recovery than adults with injuries to the brain, spinal cord and nerves. Yet children are given less hope! A child with hemiplegic cerebral palsy has it for life, but adults with stroke expect to recover.

    This site presents a Model for Recovery based on up to date information from basic neuroscience, sports physiology, medicine, surgery, therapy, motivation and time management. We provide the information you need to help your child reach for PERSONAL BEST. Best possible recovery in children requires many different approaches. There is no one simple answer. Using the right techniques at the right time can produce great results. Using the same techniques at the wrong time or in the wrong order can produce poor results. I encourage you to visit the site. Send me your questions and feedback. If this approach makes sense for you, try out the ONE YEAR PLAN with a 30 day "no risk" subscription. Let us all work together to change the outcomes for our children." 

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