Dejerine Klumpke Palsy

• Narrow cervix; a difficult vaginal birth that causes pulling and stretching of the nerves.
• Breeched baby or other abnormal position in the birth
• Over-weight baby delivery
• Induced labor or other labor abnormalities
• Substantial maternal weight gain
• Operative vaginal delivery with improper use of forceps or other delivery tools
• Gestational diabetes
• Previous delivery with this type of complications
• The second stage of labor lasts more than an hour
• Accidents and traumatic injuries that damage the nerves
• Tumors around the brachial plexus nerves

• X-rays; to locate the damaged area, and severity of the injury.
• MRI or another type of imaging scan; to locate the damage, and estimate the severity of the injury.
• Electrotherapy; to test electrical activity and nerve conduction.

• A newborn can begin the gentle massage and physical therapy
• Engage in healthy exercises to improve range of motion, reduce pain, and encourage healing in the nerves
• Engage a therapist to organize some physical methods for you. He will recommend splints to hold the hand, wrist, or arm in proper alignment.

• To repair or reconstruct nerves
• To transfer tendons for better muscle movement
• To remove scar tissues from damaged nerves
• To graft a new nerve to replace a damaged one

Symptoms

Some symptoms of klumpke’s palsy may be immediately observable, which in other cases, they are mild and unnoticed initially. 

Symptoms may include:

• Flabby lower arm (minimal arm and/or hand movement).
• Claw hand
• Stiff Joints
• The weakness of muscles and atrophy
• Sensory loss
• Poor reflexes
• Paralysis
• Lack of hand and finger movement
• Pains

A newborn with klumpke’s palsy unusually holds the arm. The elbow always remains bent.

Causes

The cause of klumpke’s palsy is trauma affecting the brachial plexus nerves. The degree of injury determines its degree of severity (mild to severe). 

Possible injuries, mild to severe, may include:

• Stretching
• Scarring
• Rupture (tearing of nerves in place)
• Avulsion (a tearing of the nerves away from the spine)

FAQ

Klumpke paralysis is a neuropathy of the lower brachial plexus which may be resulted from a difficult delivery. Usually, the eighth cervical and first thoracic nerves are injured either before or after they have joined to form the lower trunk.

• Is brachial plexus injury permanent?

For severe brachial plexus injuries, prompt surgical treatment could be needed to attempt to regain functions. Without it, you might have a permanent disability and be unable to feel or use your arm or hand.

• Which doctor treats brachial plexus injury?

People with brachial plexus injuries usually see three surgeons during one office visit. At most clinics, neurosurgeons, physical rehabilitation experts, and other specialists collaborate as a team to evaluate and treat each patient.

• What causes brachial plexus injury at birth?

The nerves of the brachial plexus can be affected by compression inside the mothers’ womb or during a difficult delivery. Injury may be caused by The infants’ head or neck pulling towards the side as the shoulder pass through the birth canal or stretching of the infants’ shoulder during the head – first delivery.

• Which newborn is most at risk for brachial plexus injury?

The incidence of brachial plexus injury ranges from 0.4 to 4 per 1,000 births. The primary risk factors are shoulder dystocia and macrosomia (birth weight >4,000g). 

Other risk factors include maternal diabetes or obesity, prolonged labor, and delivery with forceps or a vacuum extractor.