Klumpke paralysis
Klumpke's paralysis | |
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Other names | Klumpke's palsy, Dejerine–Klumpke palsy |
Brachial plexus. Klumpke paralysis primarily affects C8 and T1. | |
Specialty | Neurology |
Klumpke's paralysis 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.[3][4][5][6] The paralytic condition is named after Augusta Déjerine-Klumpke.[7][8][9]
Signs and symptoms
Symptoms can range from minor to severe and can be obvious or subtle. The right arm and hand are more likely to be affected than the left. Symptoms include atrophy of the arm or hand, claw hand, constant crying (due to pain),
Cause
Klumpke's paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a
The injury can result from difficulties in childbirth. The most common aetiological mechanism is caused by a traumatic vaginal delivery. The risk is greater when the mother is small or when the infant is of large weight. Risk of injury to the lower brachial plexus results from traction on an abducted arm, as with an infant being pulled from the birth canal by an extended arm above the head or with someone catching themselves by a branch as they fall from a tree. Lower brachial plexus injuries should be distinguished from upper brachial plexus injuries, which can also result from birth trauma but give a different syndrome of weakness known as Erb's palsy. Other trauma, such as motorcycle accidents, that have similar spinal cord injuries to C8 and T1, also show the same symptoms of Klumpke's paralysis.[citation needed]
Diagnosis
Electromyography and nerve conduction velocity testing can help to diagnose the location and severity of the lesion. Otherwise, the diagnosis is one made clinically after a thorough neurologic exam.[citation needed]
Treatment
Treatment effectiveness varies depending on the initial severity of the injury. Physiotherapy is used to increase strength of muscle and improve muscle functions. Electrical modalities such as electric nerve stimulation can also be used.[citation needed]
Occupational therapy to provide exercises and coping mechanisms to improve the patient's ability to perform activities of daily living. Goals of therapy are to improve tactile sensation, proprioception, and range of motion.[citation needed]
Acute treatment of a severe injury will involve repositioning and splinting or casting of the extremity[citation needed].
Epidemiology
Klumpke Palsy is listed as a 'rare disease' by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that Klumpke palsy, or a subtype of Klumpke palsy, affects fewer than 200,000 people in the US population.[citation needed]
See also
- Dystocia
- Erb's palsy
References
- ^ a b c Warwick, R.; Williams, P.L, eds. (1973). Gray's Anatomy (35th ed.). London: Longman. p.1046
- PMID 17330887.
- ^ Warwick, R., & Williams, P.L. (1973). pp.1037-1047
- ISBN 978-0-06-046694-7. pp.370-374
- ISBN 978-1-85605-699-1. pp.76-77
- ^ a b Shenaq S.M., & Spiegel A.J. Hand, Brachial Plexus Surgery. eMedicine.com. URL: http://www.emedicine.com/plastic/topic450.htm. Accessed on: April 13, 2007.
- PMID 18797367.
- Who Named It?
- ^ A. Dejerine-Klumpke: Contribution à l'étude des paralysies radiculaires du plexus brachial. Paralysies radiculaires totales. Paralysies radiculaires inférieures. De la participation des filets sympathiques oculo-pupillaires dans ces paralysies. Revue de médecine 1885, 5: 591-616, 739-90.
- ^ "Klumpke's Palsy". Birth Injury Justice Center. Retrieved 12 March 2023.
- ^ (Pendleton 942)Pendleton, Heidi McHugh. Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction, 6th Edition. C.V. Mosby, 052006.
- PMID 18236458.
- ISBN 978-0-8016-3227-3. pp.576, 667
- ^ ISBN 978-0-7817-9186-1.
- ^ Klumpke palsy. Stedman's Dictionary. URL: http://www.emedicine.com/asp/dictionary.asp?exact=Y&keyword=Klumpke+palsy Archived 2007-09-30 at the Wayback Machine. Accessed on: April 13, 2007.