While Klumpke’s Palsy is not the same as cerebral palsy, it is similar in that it is a birth injury that leads to partial paralysis of the muscles. In many cases, medical malpractice that occurred during childbirth is found to be the direct cause of Klumpke’s Palsy.
Klumpke’s Palsy, also known as Klumpke’s paralysis or Dejerine-Klumpke palsy, is a rare neurological disorder that affects the arm and hand. It occurs due to damage to the brachial plexus nerves that control the muscles and sensations in the arm and hand. This condition usually occurs in newborns during delivery, but it can also occur in adults due to injury, tumors, or other medical conditions. The injury most often occurs when a difficult vaginal delivery is involved. This type of injury can also trigger a condition known as Horner’s syndrome.
1. Understanding Klumpke’s Palsy
Klumpke’s Palsy is a condition that affects the lower brachial plexus nerves. These nerves run from the spinal cord in the neck to the arm and hand, controlling the movement and sensation of the arm and hand. The condition results from the stretching or tearing of the nerves, leading to muscle weakness or paralysis in the arm and hand.
2. Causes of Klumpke’s Palsy
Klumpke’s palsy affects the muscles of the hand and forearm and results because of difficulties that develop during childbirth. This usually happens during a difficult delivery, especially when the baby has a high birth weight and the mother is small. An extraction that is too rough can cause several different types of injuries to the lower brachial plexus.
The National Institute of Neural Disorders and Stroke states there are four types of injuries that involve the brachial plexus:
- Avulsion results when the nerve is detached from the spine.
- When the nerve is torn but not at the spine it is known as a rupture.
- In neuroma, the injured nerve is unable to transmit nervous signals because tissue formed after the nerve healed and placed pressure on it.
- When the nerve is damaged but not torn neuropraxia or stretching occurs.
3. Symptoms of Klumpke’s Palsy
The symptoms of Klumpke’s Palsy can vary from mild to severe, depending on the extent of nerve damage.
When a newborn suffers from Klumpke’s palsy, the intrinsic muscles or the hand(s) flexors of the wrist and fingers will be involved. The symptoms vary from mild to severe, contingent on the type and severity of injury to the brachial plexus. The “claw hand” is the most obvious physical manifestation of this condition. This causes the forearm to lie flat while the wrist and fingers tighten.
Some of the other symptoms one might observe in a person with Klumpke’s palsy include the following:
- Stiff joints
- Muscle atrophy
- Lack of sensation or feeling in the arm or hand that is affected
- Severe pain
- Numbness in the C8/T1
- An arm that is weak or paralyzed
- Shoulder, arm, or hand muscles that are weak or lacking in ability
- Eyelids on the opposite side of the face that droop (this may be a sign of Horner’s syndrome)
4. Diagnosis of Klumpke’s Palsy
The diagnosis of Klumpke’s Palsy is usually based on a physical examination and the medical history of the patient. The doctor may also perform nerve conduction tests, electromyography (EMG), or imaging tests such as MRI or CT scans to confirm the diagnosis.
5. Treatment of Klumpke’s Palsy
The treatment of Klumpke’s Palsy depends on the severity of the condition. Mild cases may resolve on their own without treatment, while severe cases may require surgery or physical therapy. In some cases, a combination of surgery and physical therapy may be needed to restore arm and hand function.
6. Prevention of Klumpke’s Palsy
Prevention of Klumpke’s Palsy can be done through proper prenatal care and avoiding any traumatic delivery techniques. Women who have a high risk of delivering large babies or those with breech presentations may need to undergo a cesarean section to avoid the risk of injury to the baby’s brachial plexus nerves.
Complications and Prognosis
The majority of the time, Klumpke’s palsy results following injuries from neuropraxia. In fact, in many cases, a baby can recover within six months after this type of injury. The NINDS statistics indicate patients who develop neuropraxia-related Klumpke’s palsy recover without medical intervention and even find a 90-100 percent return of function in both their arm and hand.
Those who suffer more serious cases of brachial plexus injuries may find the consequences of those injuries last for years or sometimes even result in lifetime disabilities that affect the arm, hand, or fingers. Sometimes surgery may help improve function by removing the scar tissue from the nerves that are affected.
Parents of children with Klumpke’s palsy may wish to reach out to a local birth injury attorney for a free consultation in order to explore any possible claims against the hospital and/or doctor.