Klumpke Palsy: Klumpke palsy, also known as Klumpke paralysis, is a type of lower brachial plexus injury that affects brachial plexus injury at birth. It is caused by an injury to the first thoracic nerve (T1) and the eighth cervical nerve (C8), all of which come from the spinal cord. The brachial plexus is a network of spinal nerves that originates in the posterior of the neck, extends within the axilla (armpit), and gives rise to nerves to the upper limb.
If a baby’s arm or shoulder is pulled or wrenched during childbirth, the brachial plexus nerves can be stretched, torn, damaged, or severed, causing a number of temporary or permanent disabilities.
Klumpke Palsy Causes and Risk Factors
Klumpke palsy is caused by tearing the C8 and T1 nerves when the arm is extended above the shoulder in an exaggerated way. This brachial plexus injury at birth typically happens during difficult vaginal childbirth due to shoulder dystocia, when the baby is extracted from the birth canal with its arms above its head.
There are four types of acute injury that can lead to Klumpke paralysis. These include:
Neuropraxia: The most common and least severe injury, neuropraxia is defined by stretching of the nerve without tearing.
Neuroma: Neuroma occurs when the injury has healed but created scar tissue that puts pressure on the surrounding nerves, limiting nerve signals to the arm and hand.
Rupture: The nerve is torn but is still connected to the spinal cord.
Avulsion: The C8 and/or T1 nerve is completely severed from the spine. This is the most severe injury that can lead to Klumpke’s palsy.
Risk Factors for Klumpke palsy
- The baby is larger than average (but still a normal weight for its size)
- Multiple pregnancies (twins, triplets, etc.)
- The mother has diabetes or is overweight/obese
- Labor has to be induced
- Breech-delivery births
- Operative vaginal birth using forceps or another surgical tool is required to bring the baby through the birth canal.
Also, Like Erb’s Palsy: Symptoms, Causes & Treatment
Klumpke’s Palsy Symptoms
Whether a baby has minor neuropraxia or full avulsion, Klumpke’s palsy can present a number of symptoms. These include numbness, tingling, or partial loss of feeling in the hand, wrist, and/or forearm. The most severe symptom is a “claw hand” where the infant’s affected hand and wrist are tightened against the body. In more severe cases, your child will experience partial or full paralysis in the lower part of their arm and hand. In some cases, it can also affect a child’s vision, resulting in constricted pupils (Drooping of the eye on the opposite side of the face).
Klumpke Palsy Treatment
The severity of Klumpke Paralysis is an important factor in how a physician will treat the injury. The most common form of this injury is likewise the least severe: simple stretching of the nerves. Most babies who suffer from this version will improve without surgery. The treatment options –
- Physical therapy
- Surgery
- Medications
Physical Therapy
Physical therapy for Klumpke palsy can usually speed up the healing process. Physical therapy also prevents stiffness from setting the joints.
Surgery
Even if the baby is recovering on their own, a physician may want to use surgery. The healing process could result in scar tissue, which can interfere with the performance of this area. Unless the scar tissue is physically eliminated, it may always be a problem.
Medications
Medication may become essential as Klumpke palsy can be effective for a persistent burning feeling or another type of pain. Topical treatments and prescription pills can help relieve this symptom.
