Information for Healthcare Professionals

There are many degrees of severity of brachial plexus injuries. The first consideration is the number of nerves affected. Often the first two nerves of the brachial plexus are injured; these children will have more muscle weakness in their shoulder and elbow (Erb’s palsy). If all five nerves are affected, weakness or paralysis can affect the entire arm and hand.

The second consideration is the severity of injury to the nerve. If the nerve fibers have a mild stretching injury, the child will recover muscle use quickly. If more fibers are stretched or torn, it will take longer for muscles to work properly and they may be weaker. A nerve that is completely pulled apart cannot repair itself so these muscles will not regain any strength. 

Most children have sufficient recovery to have good functional use of their arm. Usually, there is some residual weakness in that arm. Some injuries are serious enough that they may not get better on their own.  Surgery may be an option for children with more severe injuries.

Treatment of Brachial Plexus Palsy

We recommend to families that they begin physiotherapy, range of motion exercises, tactile and visual stimulation, positioning exercises (such as tummy time) and strengthening exercises to encourage the child to use their affected arm and hand as soon as the child is developmentally ready.

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The Brachial Plexus Clinic at BC Children’s Hospital is directed by Dr. Cynthia Verchere, pediatric plastic surgeon.

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