Klumpke’s Palsy

What is Klumpke’s Palsy?

Klumpke’s palsy is a form of brachial plexus palsy as it affects the lower portion of the brachial plexus nerves. The brachial plexus nerves are a network of 5 nerves that vitalize the back of the neck, the armpit, and the upper limbs. Klumpke’s palsy affects the lower 2 of these 5 nerves, causing paralysis in the forearm and the hand. The wrist flexors may also be involved. Klumpke’s palsy is said to be a rare condition, only affecting 200,000 people in the United States.

What are the Types of Nerve Damage in Klumpke’s Palsy?

Nerves are very sensitive and the paralysis of Klumpke’s palsy can affect a child even if the nerves are slightly damaged. There are different degrees of damaged, however: avulsion is the most severe form in which the nerve is actually torn from the spine, rupture when the nerve has been torn but not at the spinal connection, neuroma is when the nerve has torn but it has healed itself and the scar tissue pressures the nerve unduly, and neuropraxia or stretch when the nerve has been damaged but not torn. All degrees can cause sensitivity and all degrees can cause paralysis.

What are the Symptoms of Klumpke’s Palsy?

Even the slightest nerve damage can result in numbness or loss of feeling for your child anywhere in the forearm, wrist, or hand.

However, symptoms are generally more severe, and because the child is usually unable to move his or her forearm, hand, and possibly wrist flexors, the child will appear to have a claw-like hand. If Klumpke’s palsy is related to Horner’s Syndrome, the child will also have a miosis (constricted pupil) in the affected eye.

What Causes Klumpke’s Palsy?

Klumpke’s palsy happens as Erb’s palsy does: it’s most commonly a condition labeled shoulder dystocia, when the baby is delivered vaginally and the shoulder gets caught on the pubic bone.

Klumpke’s palsy and Erb’s palsy can also happen if the baby is proportionately too big for the birth canal (cephalo-pelvic disproportion called CPD) causing the baby’s head to turn abnormally from his or her shoulder, or from the strain of being pushed through the birth canal uncomfortably.

The baby can also have Klumpke’s palsy or Erb’s palsy when he or she is born face first (causing the neck undue harm from being pulled out that way), or when born feet first (and the arms come out above the baby’s head).

How is Klumpke’s Palsy Different from Erb’s palsy?

While Klumpke’s palsy (Dejerine-Klumpke’s Palsy) and Erb’s palsy (Erb-Duchenne Palsy) can be similarly caused, they’re still two very different injuries. Klumpke’s palsy affects the lower brachial plexus Nerves and Erb’s palsy affects the upper brachial plexus nerves.

While brachial plexus palsy indicates damage to the brachial plexus nerves, only Erb’s palsy is a synonym for brachial plexus Palsy –not Klumpke’s palsy. Klumpke’s palsy is a term that is intended to be independent.

What is the Treatment for These Damaged Nerves?

Sometimes nerves heal on their own. If a child experiences paralysis due to neuroma (when the nerve has healed itself but the scar tissue still interferes with normal electrical communication), surgery may be required to repair that nerve so that it can heal cleanly.

For the nerves that don’t heal on their own, surgery may be an option. Generally all children that experience any form of brachial plexus nerve damage have to go through physical therapy so that they can bring exercise and blood flow to the area and to build up the responsive muscles. Healing can take anywhere from 3 to 4 months to 2 years, and children are generally expected to have a 90-100% recovery rate.