9. Erb-Duchenne Palsy
William Smellie, a British obstetrician is credited
with the first medical description of obstetric
brachial plexus palsy.
1861- Benjamin Amand Duchenne coined term
‘obstetric palsy of the brachial plexus’
1874 - Wilhelm Heinrich Erb concluded his thesis
on adult brachial plexus injuries
15. Muscle weakness
External rotators and abductors of
the shoulder/arm.
Flexors of the forearm.
Extensors of the fingers (C7).
Diaphragm descent (C4).
16. Muscle weakness
• Moro, biceps and radial reflexes
are absent on the affected
extremity however,
• grasp reflex remains intact.
17. Klumpke’s Palsy
1885 -Augusta Dejerine-Klumpke
neurologist and neuroanatomist
diagnosed total brachial plexus
radicular paralysis with
oculopupillary involvement in a
patient
23. Horner syndrome
Bernard-Horner syndrome and oculo-
sympathetic palsy
Injury to cervical sympathetic ganglions.
Enophthalmos, partial ptosis, swelling of
the lower eyelid, miosis , unhydrosis and
heterochromia.
Loss of ciliospinal reflex.
24. Complications
Fracture of the clavicle
Fracture of the humerus
Subluxation of the cervical spine
Cervical cord injury
Facial nerve palsy
Phrenic nerve palsy
26. Management
X-rays to exclude fractures and examination
for phrenic nerve paresis are important.
Other investigations -
Electromyography,
NAP, SEP,
Nerve conduction studies,
CT myography and
MRI.
27. Management
Most cases of OBPI resolve spontaneously
in ~ 4 months to 2 year after delivery.
To prevent contractures, physiotherapy
using wrist splits after 7days
immobilization.
Surgery if movement doesn’t return after 3
months and electrophysiology indicate a
poor prognosis.