Dejerine Klumpke Palsy

Home / Dejerine Klumpke Palsy

WHAT IS DEJERINE-KLUMPKE PALSY? Dejerine-Klumpke palsy is a condition that affects the lower arm, wrist, and hand. It can occur in newborns who suffered nerve damage because of complications during labor and delivery. This condition is also known as Klumpke’s Palsy. Klumpke’s palsy is a medical condition, most often a birth injury that results from […] Read More

Top Doctors For Dejerine Klumpke Palsy Treatments

Top Hospitals For Dejerine Klumpke Palsy Treatments

Dejerine Klumpke Palsy

WHAT IS DEJERINE-KLUMPKE PALSY? Dejerine-Klumpke palsy is a condition that affects the lower arm, wrist, and hand. It can occur in newborns who suffered nerve damage because of complications during labor and delivery. This condition is also known as Klumpke’s Palsy. Klumpke’s palsy is a medical condition, most often a birth injury that results from damage to specific nerves of the brachial plexus. The brachial plexus (network) is the network of nerves that sends signals from your spinal cord to your shoulder, arm, and hand.  A brachial plexus injury occurs when these nerves are stretched, compressed, or in extreme cases ripped apart or torn away from the spinal cord. This is expressed as brachial plexus palsy, otherwise called klumpke’s palsy. In general, klumpke paralysis refers to a kind of paralysis, even though it does not necessarily mean total paralysis. Klumpke paralysis goes with a range of symptoms. RISKS Childbirth usually results in birth trauma and injury. Potential complications of pregnancy and childbirth are likely to increase the risk of developing klumpke paralysis.  Those may include:
  • 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
SPECIALITY Neurology. DIAGNOSIS Oftentimes, observation of symptoms is enough to clue for your doctor to diagnose klumpke paralysis.  To confirm the diagnose, your doctor may order the following test:
  • 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.
TREATMENT There are several treatment options for klumpke’s palsy. Milder cases, such as those caused by stretch injury, usually resolve in the first 6 months on their own. In mild cases; your doctor will likely recommend you begin with non-surgical treatment.
  • 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.
In more severe cases; the nerve is torn, movement may be paralyzed. A child may need surgery as an intervention. However, treatment is usually conservative, beginning with therapy and advancing to surgical procedures. If there is no improvement after three to six months, surgery becomes the last option. Surgery When all intervention fails, surgery stands out as the final and last option of rescue:
  • 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
PROGNOSIS Most babies recover from klumpke’s palsy. Nevertheless, compared to nerve damage higher in the arm, the injuries those result in the lower arm palsies are less likely to recover immediately.  Most infants with klumpke paralysis have the more mild form of injury (neuropraxia) and often recover within 6 months. Some infants will require surgery. Rarely, infants with klumpke’s palsy will have some permanent damage.

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

  • What nerves are affected in klumpke’s palsy?
  • 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.