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Klumpke paralysis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:


Overview

Klumpke’s paralysis or Klumpke’s palsy or Dejerine-Klumpke palsy is palsy of the brachial plexus.

A form of brachial plexus injury in which there is paralysis of the muscles of the forearm and hand due to a childbirth injury to the roots of eighth cervical C8 and first thoracic T1 nerves or the lower part of the brachial plexus, a network of spinal nerves that originates in the back of the neck, extends through the axilla (armpit), and gives rise to nerves to the upper limb.[1][2]

The risk is greater when the mother is small or when the infant is of large weight.

Historical Perspective

Classification

Pathophysiology

Causes

Most Common Cause

  • Traumatic Vaginal Delivery

Other Causes

  • Motorcycle accidents involving spinal cord injury at the level C8-T1
  • Injuries resulting in traction during arm abduction, e.g., catching onto a branch to break a fall from a tree

Differentiating Klumpke paralysis from Other Diseases

Epidemiology and Demographics

Incidence/prevalence

Klumpke Palsy is listed as a ‘rare disease’ by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that Klumpke Palsy, or a subtype of Klumpke Palsy, affects less than 200,000 people in the US population.

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Symptoms include paralysis of intrinsic hand muscles, and ulnar nerve distribution numbness. Involvement of T1 may result in Horner’s syndrome. It can be contrasted to Erb-Duchenne’s palsy, which affects C5 and C6.

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

See also

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References

  1. Shenaq SM, Spiegel AJ. Hand, Brachial Plexus Surgery. eMedicine.com. URL: http://www.emedicine.com/plastic/topic450.htm. Accessed on: April 13, 2007.
  2. Klumpke palsy. Stedman’s Dictionary. URL: http://www.emedicine.com/asp/dictionary.asp?exact=Y&keyword=Klumpke+palsy. Accessed on: April 13, 2007.

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