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Detailed information of KLUMPKE PARALYSIS
KLUMPKE PARALYSIS
DEFINITION:
A rare form of brachial palsy due to injury to the C7, C8, and T1
nerves resulting in paralysis and Horner's Syndrome.
EPIDEMIOLOGY:
- incidence: ?
- age of onset:
- risk factors:
PATHOGENESIS:
- injury to the C7, C8, and T1 -> paralysis
- injury to the sympathetic fibres of the 1st thoracic root ->
Horner's Syndrome
CLINICAL FEATURES:
- paralysis of upper limb, lower limb, and/or hand
2. Horner's Syndrome
- ipsilateral ptosis and miosis (anisocoria)
- apparent enophthalmos with slight elevation of the lower lid
- may be a decrease in facial sweating
- increased amplitude of accommodation
- ocular signs may pass undetected for years in Klumpke's
3. Complications
- deltoid muscle atrophy -> shoulder drop
INVESTIGATIONS:
MANAGEMENT:
- to prevent the development of contractures
- abduct arm to 90 degrees, externally rotate shoulder, full
suppination of forearm, slight elevation of wrist with palm
turned toward the face
- place in splint or brace intermittently (when asleep,
between meals, etc.) for 1-2 weeks
2. Lower Arm Paralysis
- splint wrist in the neutral position with padding placed
in the fist for 1-2 weeks
3. Total Arm Paralysis
- use procedures for both upper and lower arm paralysis
2. Physiotherapy
- gentle massage & range of motion exercises started by 7-10
days
- also active and passive corrective exercises
3. Surgery
- indicated if paralysis persists without improvement for 3-6
months
- neuroplasty, neurolysis, end-to-end anastomosis of nerve
ends
4. Prognosis
- depends upon the extent of the injury
- injured (edema, hemorrhage) - return of function in a few
months
- laceration - permanent damage
- paralysis of the upper arm has a better prognosis than
paralysis of the lower arm
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Pediatric Database - KLUMPKE PARALYSIS
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