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Klumpke paralysis is a rare type of birth injury to the nerves around a newborn’s shoulder, known as the brachial plexus. Most types of brachial plexus injuries affect the shoulder and upper arm. Klumpke paralysis affects the movement of the lower arm and hand. Signs and symptoms include weakness and loss of movement of the lower 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.
Klumpke paralysis is caused by an injury to the nerves of the brachial plexus that which may result during birth due to a a difficult delivery. This injury can cause a stretch injury (neuropraxia), scarring, or tearing of the brachial plexus nerves. Tearing is called an "avulsion” when the tear is at the spine, and “rupture” when it is not. Diagnosis of Klumpke paralysis is made at birth by physical examination. Sometimes x-rays and other tests are done to determine the extent of the nerve damage. 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 paralysis will have some permanent damage. **
Source: GARD Last updated on 05-01-20
The prognosis of infants and children Klumpke paralysis will depend on the severity of the injury, the time of onset, and initial (early) rate of improvement. For torn nerves (avulsion and rupture injuries), there is no potential for recovery unless surgical reconnection is made in a timely manner. Most individuals with neuropraxia injuries recover spontaneously with a 90-100% return of function. It is estimated that up to 88% of infants recover by 4 months, and 92% by 12 months.
Last updated on 05-01-20
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 the stretch injuries (neuropraxia). After 4 months, additional treatment options may include:
Last updated on 05-01-20
Ruchelsman DE, Pettrone S, Price AE, Grossman J. Brachial Plexus Birth Palsy: An overview of early treatment options. Bulletin of the NYU Hospital for Joint Diseases. 2009;67(1):83-9.
Last updated on 04-27-20
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