What Is Klumpke’s Palsy and What Can You Do?
Also called Klumpke’s paralysis, Klumpke’s palsy is a condition that occurs when the lower nerves of the brachial plexus are damaged in a birth injury. The brachial plexus is the network of nerves located near the neck that control the nerves of the shoulder, arm, hand, and fingers on that side of the body. If a baby’s arm or shoulder is pulled or wrenched during childbirth, the brachial plexus nerves can be stretched, torn, damaged, or severed, causing a number of temporary or permanent problems and/or disabilities.
Of the cluster of five nerves that make up the brachial plexus, if the lower two are damaged, the resulting condition is called Klumpke’s palsy, a disorder which affects roughly 200,000 people in the US.
Causes of Klumpke’s Palsy
Like Erb’s palsy, Klumpke’s palsy is always caused by damage to the brachial plexus nerves. However, this damage can be caused by a number of different birth injuries. These include but are not limited to:
- Cephalopelvic disproportion (CPD) – The baby is too big to safely fit down the birth canal, and stress is placed on one or both arms or shoulders during labor and delivery.
- Shoulder dystocia – The baby’s head was able to fit through the birth canal and come out, but the shoulders are impacted on the pelvic bone and cannot fit through.
- Breech delivery – If the arms go over the head, as they tend to do in a breech delivery, one or both arms my experience excessive stress and pulling.
- “Turtle syndrome” (face-first delivery) – if the baby’s face is turned so that it leads the body, it can put the shoulders and arms at an awkward angle, causing shoulder dystocia or other strain on one or both arms.
These are just a few of the most common birth injuries that can cause Klumpke’s palsy. In most cases, a good doctor should be able to see the risk factors that increase the chances of an injury and call for a cesarean section or take other medical precautions to keep both baby and mother safe and healthy.
Types and Severity of Klumpke’s Palsy Nerve Damage
Klumpke’s palsy can range in severity from very mild and temporary to severe and permanent nerve damage. The types and severity of the nerve damage associated with Klumpke’s palsy include:
- Neuropraxia – The nerves are stretched and may be slightly torn. Your baby may have some discomfort, numbness, pain, and motor skills issues for a period of time, but the nerves will generally heal on their own.
- Neuroma – The nerves have been torn and have healed on their own, but scar tissue has formed at the site of the injury. Pressure from this scar tissue can cause symptoms of Klumpke’s palsy to persist.
- Rupture – One or both nerves have been torn but they remain connected to the spine.
- Avulsion – One or both nerves have actually been torn away from the spine.
Symptoms of Kumpke’s Palsy
Whether a baby has minor neuroplaxia or full avulsion, Klumpke’s palsy can present a number of symptoms. These include numbness, tingling, or partial loss of feeling in the hand, wrist, and/or forearm. In more severe cases, your child will experience partial or full paralysis in the lower part of their arm and hand. This could result in the inability to grip objects and the hand curling like a claw. In some cases, it can also affect a child’s vision, resulting in constricted pupils (miosis).
Treatment Options for Klumpke’s Palsy
In some cases, as with neuroplaxia, the brachial plexus nerves will heal on their own, but if left untreated many cases of Klumpke’s palsy will result in permanent disability or disfigurement. In fact, even with neuroplaxia, if the nerves heal with too much scar tissue, neuroma can develop, which will have lasting symptoms.
Treatment options for Klumpke’s palsy include different forms of physical therapy to help improve flexibility, range of motion, strength, and dexterity; medication to relax muscles and help improve muscle balance; surgery to repair nerves; and/or occupational therapy to help your child learn to live with any lasting disabilities they may have.
For more information on Klumke’s palsy and other birth injuries, contact us at Birth Injury Center today to schedule a free consultation.