Klumpke’s Palsy in Babies and Newborns

Klumpke’s palsy, also called Klumpke’s paralysis, is a severe medical condition caused by birth trauma or nerve damage from a brachial plexus injury according to the National Institute for Neurological Disorders and Stroke. Many brachial plexus injuries happen when a baby’s shoulders become impacted during delivery and the brachial plexus nerves stretch or tear. The brachial plexus itself is a collection of nerves running from the spinal cord through the armpit. 

This crucial part of the nervous system carries signals from the brain to the shoulder, arm, and hand. Klumpke’s palsy impacts the lower brachial plexus, affecting the use of the hand and wrist. This differs from Erb’s palsy, which is a paralysis of the upper brachial plexus and impacts the shoulder and upper arm. Lower brachial plexus injuries are more common with breech babies and other difficult births. While the majority of Klumpke’s palsy occur during birth, some people develop this condition later in life due to accidents or injuries damaging their nerves. 

The main symptom of Klumpke’s palsy is weakness in the hand, arm, and wrist. Other symptoms can be subtle or obvious depending on the injury severity. Claw hand, when the hand curls in on itself similar in look to a claw. Muscle weakness. Limited range of arm motion. Arm or hand paralysis. Arm or hand atrophy. Crying from pain or discomfort. If a newborn experiences any of these issues, a physician needs to examine the affected arm and brachial plexus nerves to see just how serious the issue is.

This first step gives the doctor insight into the arm’s weakness, range of motion, and other factors that contribute to a proper diagnosis. Tests for Klumpke’s palsy include X-rays, electromyography, ultrasounds, and nerve conduction studies. Doctors usually don’t start treatment before making their diagnosis. If they prescribe the wrong treatment plan, it could not only be ineffective but could cause additional harm. Klumpke’s palsy’s treatment options depend on the condition’s severity. In some babies, near-normal or normal movement comes back on its own.

If there aren’t any broken bones or joint dislocation, treatment can focus on support, stretching, and muscle strengthening through light exercise. Severe cases, however, might require surgery such as nerve grafting and nerve grafting where a doctor takes healthy nerves from somewhere else in the body and implants them to restore feeling and range of motion in the infant’s affected arm. Avulsions and ruptures need to have the damaged nerve repaired or replaced so the infant can develop normally and avoid atrophy and paralysis.

Doctors often use neuromuscular electrical stimulation devices to improve blood flow and aid muscle building. Children born with Klumpke’s palsy may need ongoing physical therapy to maintain strength in their lower and upper limb and retain as large a range of motion as possible. The hand and forearm muscles need to be used and stimulated in order to stay strong because if paralysis occurs, they will atrophy quickly. Starting treatment quickly provides the best opportunity for improvement.

Fortunately, many babies are born with just a mild case of Klumpke’s palsy and can recover a normal range of motion and feeling in only a few months. However, more severe cases with deep damage to the nerve roots or tearing of the nerve are different. Babies with damage to the ulnar nerve where it meets the spinal column or who’ve had the nerves torn away from the spine may never recover fully. They may always experience some hand or arm weakness, and some may go through full or partial paralysis throughout their lives.

Flexors shorten over time, and shoulder dystocia may occur. Because nerve injuries can range in severity and often have different causes, their prognosis varies from patient to patient. Those who get Klumpke’s palsy because of tumors or a lesion may not be able to have their range of motion improved or restored. It’s always wise as an expectant mother to learn as much as you can before giving birth. There are several major risk factors that you can know about in advance that may increase the odds of developing Klumpke’s palsy.

For example, palsy is more common in mothers who have pelvic abnormalities, a small size, an older age, substantial weight gain during pregnancy, gestational diabetes, or have previously given birth to a baby affected by Klumpke’s palsy. There are also labor and delivery factors that can increase the risk of contracting Klumpke’s palsy such as labor induction, breech birth, carrying past the due date, difficulties during vaginal birth, improper use of forceps, and protracted second stage of labor.

Another risk factor includes improper quality of care from the birth physicians. If you suspect your child’s Klumpke’s palsy was caused by another person’s wrongful, negligent, or reckless actions, you should seek legal help. Contact a lawyer to review your case. You may be entitled to compensation to cover the cost of therapy and your child’s long-term care.

The Birth Injury Center is here to assist you, offering consultations and abundant resources for your own peace of mind. You can learn additional information about causes, treatments, family forums, parent support groups, and more by visiting us at birthingcenter.org