Klumpke’s palsy is also known as Klumpke’s paralysis or Dejerine-Klumpke palsy. It is a type of brachial plexus that usually affects a newborn due to birth injury. Brachial plexus injury interferes with the network of nerves that sends impulses from the spine to the shoulder and arm. Depending on the severity of the nerve damage, Klumpke’s palsy may disappear on its own whereas severe cases may require various forms of treatment.
What Is Klumpke’s Palsy?
Brachial plexus injuries such as Klumpke’s palsy occur because of the nerves in the brachial plexus are stretched, compressed or torn. Brachial plexus is a network of five nerve groups that travel from the spinal cord to wrists, fingers, arms and shoulders. They come out of the spinal cord at the cervical vertebrae in the neck and thoracic vertebrae in the back. Each nerve group controls the sensations and movement abilities of different parts of the body. In Klumpke’s palsy the first thoracic nerve and the eighth cervical nerve are injured. Older children and adults may suffer from Klumpke’s palsy because of several types of accidents, contact sports, other injuries.
Klumpke’s Palsy Causes
Klumpke’s palsy often occurs as a result of difficulties during childbirth. It usually occurs in cases in which the mother is small and the child has a high birth weight. The damage to the eighth cervical nerve and first thoracic nerve may result from improperly pulling the baby from the birth canal. If the extraction is done roughly, it may lead to several types of injuries in the lower brachial plexus such as Klumpke’s palsy.
Brachial plexus injuries may result from:
- Avulsion, or a severing of the nerve from the spine
- Rupture or tearing of nerves
- Neuroma in which scare tissue blocks the signals to the hand muscles
- Neuropraxia in which the nerve is damaged but not torn
Klumpke’s Palsy Symptoms
Klumpke’s palsy usually affects muscles of the hand and wrist. Symptoms may vary from mild to severe. The most severe manifestation of Klumpke’s palsy is a condition usually referred to as “claw hand” in which the affected forearm lies flat and wrist and fingers are tightened.
Other common symptoms of Klumpke’s palsy may include:
- Stiff joints
- Atrophy of the muscles
- Severe pain
- A limp or paralyzed arm
- No feeling or sensation in the affected arm or hand
- Drooping of the eyelids, known as ptosis
Tests for Klumpke’s Palsy
Several tests exist to diagnose Klumpke’s palsy. Most tests involve imaging techniques as they help to determine if there is any nerve damage. Usually tests are conducted when the parents or the physician notices arm weakness. Tests used to diagnose Klumpke’s palsy include MRI, electromyogram, or nerve conduction study.
Most of the cases of Klumpke’s palsy are a result of neuropraxia. In many cases, a baby may recover from this type of injury within six months. Patients who suffer from Klumpke’s palsy may recover without treatment and can regain nearly perfect hand and arm function. In situations of avulsion, the symptoms may persist for years.
Klumpke’s Palsy Treatment
In most of the cases, the severity of the injury determines a doctor’s choice of treatment. The major factors determining the choice of treatment include the type of injury and time elapsed between the occurrence of the injury and the treatment. A number of treatment options are available to treat Klumpke’s palsy. Usually physical therapy assists in relaxing the muscles and helping the patient regain normal mobility. Surgery may be required when avulsion or rupture has occurred to repair the damaged nerves. Medications may be given in cases in which the patients are in pain. Typical medicines include painkillers, ointments and prescription medications.
Klumpke’s Palsy Legal Considerations
Many cases of Klumpke’s palsy heal without the need for medical intervention. However, if your child developed Klumpke’s palsy as a result of poor conduct during the delivery, or has not healed properly, it is crucial that you speak to a qualified and experienced birth injury attorney. Such an attorney can provide you with the correct information regarding your right to seek justice.
“NINDS Erb-Duchenne and Dejerine-Klumpke Palsies Information Page.” Erb-Duchenne and Dejerine-Klumpke Palsies Information Page. National Institute of Health. Web. 28 Jan. 2015. <http://www.ninds.nih.gov/disorders/brachial_plexus_birth/brachial_plexus_birth.htm>.
“Brachial Plexus Injury.” Johns Hopkins Medicine – Neurology and Neurosurgery. Johns Hopkins Medicine. Web. 28 Jan. 2015. <http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/peripheral_nerve_surgery/conditions/brachial_plexus_injury_bpi.html>.
“Erb’s Palsy (Brachial Plexus Birth Palsy)-OrthoInfo – AAOS.” Erb’s Palsy (Brachial Plexus Birth Palsy)-OrthoInfo – AAOS. American Academy of Orthopaedic Surgeons. Web. 28 Jan. 2015. <http://orthoinfo.aaos.org/topic.cfm?topic=a00077>.