Klumpke’s Palsy

Klumpke’s palsy (also called Klumpke’s paralysis) is the result of an injury to the lower brachial plexus, a network of nerves in the neck that controls the arms. The palsy causes weakness and loss of motion in the arm and hand. Many cases of this injury are minor, and patients are often able to recover.

Klumpke’s paralysis is very rare, affecting fewer than 200,000 people in the U.S.

Klumpke’s palsy Causes and Risk Factors

Klumpke’s palsy is caused by an injury to the eighth cervical (C8) and first thoracic (T1) nerves in the lower brachial plexus. This type of birth injury is different from other brachial plexus injuries, such as Erb’s palsy, that affect the upper brachial plexus nerves.

The injury is caused by tearing the nerves when the arm is extended above the shoulder in an exaggerated way. Similar to Erb’s palsy, this injury typically occurs during difficult childbirths, when the baby is pulled from the birth canal roughly with their arms above their head. A smaller mother or an overweight baby can increase the risk of these birth complications.

The types of injuries that cause Klumpke’s paralysis are broken down into four categories:

  • 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 spine.
  • Avulsion: C8 or T1 nerve is severed from the spine. This is the most severe injury.

Symptoms and Diagnosis of Klumpke’s Paralysis

Klumpke’s paralysis causes difficulty with movement in the wrist and hand. The most severe symptom is a “claw hand,” where the infant’s affected hand and wrist are tightened against the body. Other symptoms include:

  • Weakness of the shoulder, arm, or hand
  • Paralysis or limpness in the arm
  • Stiff joints
  • Horner’s syndrome, or drooping of the eye on the opposite side of the face
  • Numbness in affected areas

If your child shows any of these symptoms, speak to your doctor. The sooner the condition is diagnosed, the earlier treatment can begin

Treatments for Klumpke’s Palsy

Like Erb’s palsy patients, children with Klumpke’s paralysis often recover over time. In neuropraxia injuries specifically, parents tend to notice significant improvement in their child’s movement in about four to six months.

Once the disorder has been diagnosed, doctors typically recommend immobilizing the affected arm and hand for one to two weeks. Then, gentle massages and exercises can help increase range of motion. For more serious cases where the nerve was severed, surgery may be recommended. Doctors will either operate on the nerve performing a graft, or transfer tendons to improve the nearby nerves.

Speak to your healthcare provider for more information about diagnosis and treatment options if your child is affected by Klumpke’s paralysis.

Klumpke’s Palsy Prognosis and Statistics

Klumpke’s paralysis is rare, and is only seen in 2-2.5 infants out of every thousand. Since most children with Klumpke’s paralysis have a neuropraxia injury, it is common for patients to make a complete recovery. In cases where the injury is more severe, patients may experience symptoms for longer, and sometimes have lifelong disabilities.

If your child has Klumpke’s paralysis, physical therapy, surgery, and even psychological treatments can help improve their quality of life.