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What is Klumpke’s Palsy?

Nephritis Misdiagnosis

Klumpke’s Palsy is a type of paralysis that affects the muscles of the hand and the forearm. Klumpke’s Palsy is caused by a lower brachial plexus injury, usually sustained during difficulties with the birthing process, which is the result of the C8 and T1 nerves being injured before or after the formation of the lower trunk of the spinal nerves. However, injuries to the brachial plexus can occur at any time and are not limited to children in the process of being birthed. Currently, Klumpke’s Palsy is classified as a rare disease by the National Institute of Health’s Office of Rare Diseases Research, which means it affects fewer than 200,000 people in the United States.

Types of Injuries that Lead to Klumpke’s Palsy

Injuries to the brachial plexus can be categorized into four types of severity. From the most severe to the least, these categories are avulsion, rupture, neuroma and neuropraxia.

Avulsion

If the spinal nerves are torn completely from the spine, this is known as avulsion.

Rupture

The nerves are considered ruptured if they are torn anywhere except for the place where they attach to the spine.

Neuroma

Neuroma occurs when the spinal nerves tear but then heal and form scar tissue. The scar tissue presses against the injured nerves and impedes the ability of those nerves to transmit signals to the muscles of the arm and hand.

Neuropraxia

A neuropraxia injury, also known as a stretch injury, occurs when the spinal nerves are injured but have not been torn. These injuries are the most common of all brachial plexus injuries that lead to Klumpke’s Palsy.

Risk Factors that can lead to Klumpke’s Palsy

The primary cause of Klumpke’s Palsy is a traumatic vaginal delivery. If the baby is pulled from the birth canal by the arm or suffers an impacted shoulder, this will result in a higher risk for Klumpke’s Palsy. The risk for complications is further augmented when the mother is below average in size and the child is abnormally large.

Short Term and Long Term Effects of Klumpke’s Palsy

Klumpke’s Palsy can cause what is known as “claw hand,” which is where the fourth and fifth fingers of the hand curl back towards the wrist. Klumpke’s Palsy also causes paralysis or numbness in the arm and hand. Klumpke’s Palsy is recognizable in children who have a limp, drooping or paralyzed arm, a lack of muscle control in the hand, arm or wrist and a lack of sensation and feeling in the hand, arm or wrist.

Treating Klumpke’s Palsy

The only way to treat avulsion and rupture injuries is to reattach the torn nerves by performing a prompt surgical procedure. Injuries caused by neuroma or neuropraxia might heal without any additional treatment, but in many cases surgery or physical therapy is needed. An average recovery timetable for a child who has suffered a neuroma or neuropraxia injury, according to the National Institute of Health, is about three to four months.

 

Sources:

ninds.nih.gov/disorders/brachial_plexus_birth/brachial_plexus_birth.htm

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