Comparison between two decades aaf elsayed frcsc, mohammed alqattan mb bs frcsc, howard m clarke md phd frcsc, cg curtis bsc pt department of plastic surgery and obstetrics, king saud university, riyadh, saudi arabia. Apr 10, 2017 palsy is a medical term for types of paralysis or partial paralysis that involve different parts of the body and may have different causes. Nerve supply to the arm and hand comes from what is known as the brachial plexus, a network formed from nerve roots in the spinal cord. Klumpke s palsy is said to account for less than 1% of all brachial plexus palsies. Isolated lower brachial plexus klumpke palsy with compound. Curtis from the section of plastic surgery and the department of rehabilitation services, the hospital for sick children, toronto, ontario, canada erbs palsy is the most common obstetric brachial plexus injury followed by total plexus palsy. When the brachial plexus is damaged between the first thoracic nerve t1 and the eighth cervical nerve c8 before or after they have joined at the lower trunk, this paralysis typically affects the lower arm and hand, and is considered klumpkes palsy. Klumpke s palsy is a rare form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth cervical c8 and first thoracic th1 nerves. Jan 07, 2019 klumpke paralysis is a rare type of birth injury to the nerves around a newborns shoulder, known as the brachial plexus. Klumpke s paralysis is a variety of partial palsy of the lower roots of the brachial plexus.
Feb 26, 2019 erbduchenne and dejerine klumpke are palsies of the brachial plexus. Departments of plastic surgery and rehabilitation services, the hospital for. Of the cluster of five nerves that make up the brachial plexus, if the lower two are damaged, the resulting condition is called klumpkes palsy, a disorder which affects roughly 200,000 people in the us. Oct 09, 2015 the national institute of healths office of rare diseases reports that less than 200,000 people are currently diagnosed with klumpkes palsy in the united states. Brachial plexus injuries interfere with the network of nerves that sends impulses from the spine to the shoulder, arm, and spine. Upper limb orthoticsbrachial plexus lesion klumpkes palsy. Most infants with klumpke paralysis have the more mild form of injury. This type of injury affects newborn babies and results because of an injury to the brachial plexus where the first thoracic nerve and the eighth cervical nerve is affected. A type of brachial birth palsy in which there is paralysis of the muscles of the distal forearm and hand all ulnar innervated muscles, plus more distal radial and medianinnervated muscles, due to a lesion of the lower trunk of the brachial plexus, or of the c8 and t1 cervical roots. If you are seeking the help of a klumpkes palsy lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases. The injury can either stretch, rupture or avulse the roots of the plexus from the spinal cord.
Klumpkes palsy risk factors clinical features prognosis. Klumpke palsy, named after augusta dejerine klumpke, is a neuropathy involving the lower brachial plexus. Most types of brachial plexus injuries affect the shoulder and upper arm. A common cause of this devastating injury occurs when the babys shoulders become lodged inside of the mother and cannot pass through. Klumpke s palsy is only one of augusta dejerine klumpke s great accomplishments as a physician and woman in medicine. Klumpkes palsy, also known as either klumpkes paralysis or dejerineklumpke palsy, is a type of brachial palsy that affects newborn babies. Klumpkes palsy is a rare form of paralysis involving the muscles of the. While initially born with a flail limb, the child regained elbow flexion at 10 weeks. Erbduchenne erbs palsy refers to paralysis of the upper brachial plexus. First, they all involve palsy, or paralysis of some type. Birth injury erbs palsy or klumpkes palsy illinois. In contrast, the more common erb duchenne palsy involves the more cephalic portion of the brachial plexus c5 to c6. Sep 07, 2018 read medical definition of klumpke s palsy.
There are references to this condition back to the the old testament, and galens histories. The hallmark of this condition is hand weakness, usually accompanied by horners syndrome. Usually the eighth cervical and first thoracic nerves are injured either before or after they have joined to form the lower trunk. Klumpkes palsy is only one of augusta dejerineklumpkes great accomplishments as a physician and woman in medicine. Klumpkes palsy, also known as klumpkes paralysis or dejerineklumpke palsy, is a brachial plexus injury that usually affects newborns as a result of a birth injury. Surgery even if the baby is recovering on their own, a physician may want to use surgery. Klumpkes paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth. Differentiating klumpkes palsy from other brachial plexus injuries. Klumpke palsy, named after augusta dejerineklumpke, is a neuropathy involving the lower brachial plexus. Obstetric brachial plexopathy erbs, klumpkes palsy. It occurs when theres an injury to the brachial plexus, specifically the upper brachial plexus at birth. The rare dejerineklumpke type of obpl falls outside this pattern and involves isolated. Klumpkes palsy cases require extensive knowledge of both the law and medicine.
Klumpkees palsy causes, clinical features and management. Erbs palsy contrasted with klumpkes and total palsy. Physical therapy also prevents stiffness from setting the joints. Risk factors associated with the development of klumpke s palsy.
Klumpke paralysis affects the movement of the lower arm and hand. Klumpke paralysis definition of klumpke paralysis by. Like erbs palsy, klumpkes palsy is always caused by damage to the brachial plexus nerves. The brachial plexus is 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.
Erbs palsy or erbduchenne palsy is a form of obstetric brachial plexus palsy. Dejerine klumpke palsy refers to damage of the c8 and t1 nerve roots resulting in sensory and motor deficits in the distribution of the ulnar nerve. Klumpke palsy is a form of brachial plexus injury usually observed in newborns following birth trauma. Klumpkes palsy causes, symptoms and treatment options. However, if your child developed klumpkes palsy as a result of poor conduct during the delivery, or has not healed properly, it is crucial that you speak to a qualified and experienced birth injury attorney. She was born is san francisco, california in 1859 to an american woman, dorothea mathilda tolle. Request pdf isolated lower brachial plexus klumpke palsy with compound. It is caused by an injury to the brachial plexus in which the first thoracic nerve t1 and the eighth cervical nerve c8 are injured before or after they have joined to form the lower trunk. May 15, 2015 klumpkes palsy is a type of birth injury that is also sometimes called klumpkes paralysis or dejerineklumpke palsy. Palsy refers to paralysis while brachial plexus is the network of nerves in the region from the neck down towards the shoulder. A 28yearold male presented with simultaneous signs and symptoms of erbs c5 and klumpkes c8, t1 palsy, with sparing of the c6 and c7 roots.
Whats the difference between cerebral palsy, erbs palsy. Dec 16, 2015 erbduchenne palsy refers to damage of the c5 and c6 nerve roots resulting in sensory and motor deficits in the distribution of commonly the suprascapular, musculocutaneous and axillary nerves. A form of brachial plexus palsy in which there is paralysis of the muscles of the forearm and hand due to an injury to the roots of eighth cervical and first thoracic roots 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. Studies of the forces involved in brachial plexus injury in adults and. Klumpkes paralysis or klumpkes palsy or dejerineklumpke palsy is a variety of partial palsy of the lower roots of the brachial plexus. Sep 06, 2018 the first known description of neonatal brachial plexus palsy bpp dates from 1779 when smellie reported the case of an infant with bilateral arm weakness that resolved spontaneously within a few days after birth.
The brachial plexus is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. Many cases of klumpkes palsy heal without the need for medical intervention. Cerebral palsy, erbs palsy and klumpkes palsy have some things in common. Obstetrical brachial plexus injuries are reported in the medical literature at a rate of 0. The patient also had an obstetric brachial plexus palsy of the right side. Historically, the management of these lesions has been conservative, with observation and physical therapy as the primary modalities. Klumpke palsy, also known as klumpke paralysis, is a type of lower brachial plexus injury that affects brachial plexus injury at birth.
Physical therapy physical therapy for klumpke palsy can usually speed up the healing process. Birth injury erbs palsy or klumpkes palsy experienced birth injury attorneys serving chicago and areas throughout illinois the majority of brachial plexus injuries occur from difficulties during childbirth, such as a shoulder dystocia or a breech presentation. Klumpke paralysis is a neuropathy of the lower brachial plexus which may be resulted from a difficult delivery1. Klumpkes palsy is a birth injury that is caused by damage to the collection of nerve fibers in a newborns spine and neck. Second, they can all be the result of birth injuries. This video is all about klumpkees palsy its causes, clinical features and management. Jan 24, 2018 this video is all about klumpkees palsy its causes, clinical features and management. Erbduchenne and dejerineklumpke palsies information page. Klumpke palsy has yet to be clearly documented in the newborn, because. No corrections have been made to the ocred text and no editing has been done. Pdf download for evaluation of a patient with klumpkes palsy open. Epidemiology the incidence of klumpke palsy is estimated at around 0. Dejerineklumpke palsy definition of dejerineklumpke palsy.
Klumpkes palsy is a rare form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth. Dejerine klumpke klumpke s palsy refers to paralysis of the lower brachial plexus. An experienced and compassionate klumpkes palsy lawyer at stern law, pllc can help you understand with the complexities of birth injury cases, and help you determine if medical negligence played a role your childs injury. The name klumpke is well known throughout the medical field, calling to mind klumpkes palsy, or lower trunk brachial plexopathy, a difficult condition encountered by physicians and surgeons. The patient presented several months ago to his local emergency room with shortness of breath, which was determined to be caused by left diaphragmatic paralysis through clinical and. Klumpkes palsy is a form of brachial plexus injury in which there is paralysis of the muscles of the forearm and hand due to an injury to the roots of the 8th cervical and the 1st thoracic nerve roots. Signs and symptoms include weakness and loss of movement of the lower arm and hand. Klumpke paralysis genetic and rare diseases information. It is caused by an injury to the first thoracic nerve t1 and the eighth cervical nerve c8, all of which come from the spinal cord. Brachial plexus injuries are caused by damage to those nerves. Mar 17, 2020 klumpke s palsy, sometimes called dejerine klumpke palsy, involves damage to the nerves which supply the small muscles of the hand. Klumpke s paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth cervical c8 and first thoracic t1 nerves are injured either before or after they have joined to form the lower trunk.
461 763 357 174 1169 1121 734 21 1127 1114 589 490 1357 637 791 35 828 863 930 141 1334 892 559 1501 592 674 108 1332 1190 1362 348 407 928 1227 471 129 573 1111 1322 1251 408 451 99