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 rare, and is only seen in 2 – 4 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.
Because this birth injury is often an avoidable result of medical malpractice, parents may be able to file a Klumpke’s palsy lawsuit to receive compensation that will help pay for treatment, ongoing care, and other related costs.
Klumpke’s Palsy vs. Erb’s Palsy
Klumpke’s palsy and Erb’s palsy result from similar causes, and symptoms may often be confused. The primary distinction is which area of the brachial plexus in which the damage occurs.
Klumpke’s Palsy vs. Erb’s Palsy
|Klumpke’s Palsy||Erb’s Palsy|
|Klumpke’s palsy results from damage to cervical spinal nerve 8 (C8) and thoracic nerve 1 (T1).||Erb’s palsy results from damage to cervical spinal nerves 5 and 6 (C5 and C6).|
Klumpke’s palsy is sometimes called Dejerine-Klumpke palsy, Klumpke paralysis, or Horner’s syndrome.
Klumpke’s Palsy Causes and Risk Factors
Klumpke’s palsy is caused by tearing the C8 and T1 nerves when the arm is extended above the shoulder in an exaggerated way. This birth injury typically occurs during difficult vaginal delivery due to shoulder dystocia, when the baby is pulled 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.
Prevention and Reducing the Risk of Klumpke’s Palsy
The most common way to prevent the risk of developing Klumpke’s palsy is to avoid a vaginal delivery by scheduling a cesarean section instead. The highest risks are faced by small mothers and large babies. However there are a variety of other risk factors that could indicate potential birth trauma leading to Klumpke’s palsy.
Risk Factors for Klumpke’s 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
Doctors may employ a number of techniques during birth to prevent or reduce the risk of shoulder dystocia that can lead to Klumpke’s palsy. These include:
- Exerting pressure to the mother’s lower abdomen, either directly or by raising her thighs to her belly
- Turning the baby while still in the uterus or birth canal
- Surgically increasing the vaginal opening (episiotomy)
- Performing a cesarean section (c-section) to avoid a difficult delivery
Klumpke’s Palsy Symptoms
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
- Deformed or “claw” hand
- Stiff joints
- 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
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 severe 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.
Common Therapies for Klumpke's Palsy
- Range-of-motion exercise
- Physical therapy
- Nerve graft
- Neuroma excision
- Tendon transfer
Speak to your healthcare provider for more information about diagnosis and treatment options if your child is affected by Klumpke’s paralysis. Treatment and recovery for this type of avoidable birth injury can be costly, but you may be able to receive compensation to help pay for medical bills, lodging, lost income and other expenses. If you have questions about your legal rights, please contact us.
Medical, Financial and Legal Support
There are several national nonprofit organizations and advocacy groups that help families affected by Klumpke’s palsy and other brachial plexus birth injuries. These include:
- Brachial Plexus Palsy Foundation
- National Rehabilitation Information Center
- United Brachial Plexus Network
In addition, parents of infants who have suffered a birth injury that lead to Klumpke’s palsy or another brachial plexus condition may have recourse to file a lawsuit against the doctor, hospital or medical center responsible if any malpractice or negligence has been committed.