Symptoms, Causes, Prognosis and Treatment of Klumpke Paralysis in Infants Due to Brachial Plexus Injury

Anterior view of right brachial plexus.

Anterior view of right brachial plexus. Klumpke’s paralysis (or Klumpke’s palsy or Dejerine–Klumpke palsy) is a variety of partial palsy of the lower roots of the brachial plexus.[1][2] 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.

Klumpke Paralysis (may also be referred to as Klumpke’s Palsy or Dejerine-Klumpke Palsy) is a type of brachial palsy in newborns.

Signs and Symptoms

Signs and symptoms include weakness and loss of movement of the arm and hand.

Some babies experience drooping of the eyelid on the opposite side of the face as well.  This symptom may also be referred to as Horner syndrome.

Causes of Klumpke’s Palsy (Paralysis)

Klumpke paralysis is caused by an injury to the nerves of the brachial plexus which may result from a:

This injury can cause a stretching (neuropraxia,), tearing (called “avulsion” when the tear is at the spine, and “rupture” when it is not), or scarring (neuroma) of the brachial plexus nerves.

Most infants with Klumpke paralysis have the more mild form of injury (neuropraxia) and often recover within 6 months.

Treatment

The  affected arm may be immobilized across the body for 7 to 10 days.  For mild cases gentle massage of the arm and range-of-motion exercises may be recommended. For torn nerves (avulsion and rupture injuries), symptoms may improve with surgery.

Most infants recover from neuropraxia within 4 months. Parents or guardians of infants that show no evidence of spontaneous recovery at 4 months may be counseled regarding additional treatment options. These treatment options may include:

  • Surgery on the nerves (e.g., nerve grafts and neuroma excision)
  • Tendon transfers to help the muscles that are affected by nerve damage work better

Prognosis

The  affected arm may be immobilized across the body for 7 to 10 days. For mild cases gentle massage of the arm and range-of-motion exercises may be recommended.  For torn nerves (avulsion and rupture injuries), symptoms may improve with surgery.

Most infants recover from neuropraxia within 4 months. Parents or guardians of infants that show no evidence of spontaneous recovery at 4 months, may be counseled regarding additional treatment options. These treatment options may include:

  • Surgery on the nerves (e.g., nerve grafts and neuroma excision)
  • Tendon transfers to help the muscles that are affected by nerve damage work better

Did your baby suffer a brachial plexus injury causing paralysis or palsy as the result of a medical negligence?

If you, or your baby suffered a severe injury as the result of a Cesarean section delivery, medical neglect, or malpractice you may be entitled to compensation. If you have questions about what happened and why your baby was injured, don’t trust an insurance company or doctor to provide you with all the information you need, call our lawyers today and take your first step in protecting you and your baby’s rights.

We offer a free legal consultation so you can tell us about your unique situation. We will be able to tell you if you have a case, the value of your case, and discuss your various legal options. We encourage you to at least talk to us and learn what your rights are so that you will have knowledge to help you make the best decision for your family about how to protect those rights for your child.

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The Los Angeles area law firm of Donahue & Horrow, L.L.P., handles birth injury cases throughout California. The initial consultation will be at no cost. All cases are billed on a contingency fee basis — there will be no cost to you unless or until we recover compensation in the form of an insurance settlement or trial award.

Contact us today and you will have taken your first step towards ensuring your child’s future needs will be met.

 


Sources

  1. Brachial palsy in newborns. MedlinePlus. 2009; http://www.nlm.nih.gov/medlineplus/ency/article/001395.htm. Accessed 2/24/2010.
  2. Hill A. Neurological problems of the newborn. In: Bradley WG et al. Neurology in Clinical Practice, 5th ed. Philadelphia, PA: Butterworth-Heinemann; 2008;
  3. NINDS Erb-Duchenne and Dejerine-Klumpke Palsies Information Page National. Institute of Neurological Disorders and Stroke. 2007; http://www.ninds.nih.gov/disorders/brachial_plexus_birth/brachial_plexus_birth.htm.