176:. 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
37:
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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,
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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), intrinsic minus hand deformity,
698:
221:
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.
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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.
169:). The classic presentation of Klumpke's palsy is the "claw hand" where the forearm is supinated, the wrist extended and the fingers flexed. If Horner syndrome is present, there is miosis (constriction of the pupils) in the affected eye.
691:
76:. 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. The paralytic condition is named after
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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.
149:
nerves are injured either before or after they have joined to form the lower trunk. The subsequent paralysis affects, principally, the intrinsic muscles of the hand (notably the
495:
Huang YG, Chen L, Gu YD, Yu GR (May 2008). "Histopathological basis of Horner's syndrome in obstetric brachial plexus palsy differs from that in adult brachial plexus injury".
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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,
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180:. 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.
485:(Pendleton 942)Pendleton, Heidi McHugh. Pedretti's Occupational Therapy: Practice Skills for Physical Dysfunction, 6th Edition. C.V. Mosby, 052006.
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Klumpke's paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a
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Acute treatment of a severe injury will involve repositioning and splinting or casting of the extremity.
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Shoja MM, Tubbs RS (August 2007). "Augusta DĂ©jerine-Klumpke: the first female neuroanatomist".
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395:"Augusta DĂ©jerine-Klumpke, M.D. (1859-1927): a historical perspective on Klumpke's palsy"
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Shenaq S.M., & Spiegel A.J. Hand, Brachial Plexus
Surgery. eMedicine.com. URL:
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http://www.emedicine.com/asp/dictionary.asp?exact=Y&keyword=Klumpke+palsy
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Pedley, Timothy A.; Rowland, Lewis P.; Merritt, Hiram
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The Atlas of the Human Body: A Complete Guide to How the Body Works
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Ulgen BO, Brumblay H, Yang LJ, Doyle SM, Chung KC (August 2008).
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Glanze, W.D.; Anderson, K.N.; Anderson, L.E, eds. (1990).
536:(3rd ed.). St. Louis, Missouri: The C.V. Mosby Co.
533:
Mosby's
Medical, Nursing & Allied Health Dictionary
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Page 512: Lower
Radicular Syndrome (Klumpke Paralysis)
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Warwick, R., & Williams, P.L. (1973). pp.1037-1047
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569:. Hagerstwon, MD: Lippincott Williams & Wilkins.
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161:) and the flexors of the wrist and fingers (notably
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47:. Klumpke paralysis primarily affects C8 and T1.
321:Tortora, G.J. & Anagnostakos, N.P. (1990).
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381:http://www.emedicine.com/plastic/topic450.htm
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329:(6th ed.). New York: Harper & Row.
172:The injury can result from difficulties in
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589:Klumpke palsy. Stedman's Dictionary. URL:
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261:Warwick, R.; Williams, P.L, eds. (1973).
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30:Klumpke's palsy, Dejerine–Klumpke palsy
101:distribution numbness. Involvement of
355:. Leicester, U.K.: Silverdale Books.
7:
971:Infant respiratory distress syndrome
325:Principles of Anatomy and Physiology
976:Transient tachypnea of the newborn
412:10.1227/01.NEU.0000320420.25035.A7
14:
754:Twin-to-twin transfusion syndrome
265:(35th ed.). London: Longman.
1272:Vertically transmitted infection
1364:Fetal Alcohol Spectrum Disorder
1314:Group B streptococcal infection
882:Intrauterine growth restriction
405:(2): 359–66, discussion 366–7.
707:Conditions originating in the
600:. Accessed on: April 13, 2007.
383:. Accessed on: April 13, 2007.
141:in which the eighth cervical (
1:
1056:Vitamin K deficiency bleeding
1215:Periventricular leukomalacia
1033:Persistent fetal circulation
981:Meconium aspiration syndrome
1124:Intraventricular hemorrhage
466:Birth Injury Justice Center
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1129:Germinal matrix hemorrhage
1119:Velamentous cord insertion
1010:Bronchopulmonary dysplasia
167:flexor digitorum profundus
72:of the lower roots of the
1159:Necrotizing enterocolitis
868:Large for gestational age
864:Small for gestational age
43:
34:
78:Augusta DĂ©jerine-Klumpke
68:is a variety of partial
1321:Neonatal conjunctivitis
812:Single umbilical artery
802:Umbilical cord prolapse
749:Placental insufficiency
722:complicating pregnancy,
210:, and range of motion.
1297:ureaplasma urealyticum
1005:Wilson–Mikity syndrome
929:Brachial plexus injury
165:and ulnar half of the
139:brachial plexus injury
1245:Congenital hypertonia
1136:Anemia of prematurity
844:Shoulder presentation
145:) and first thoracic
1250:Congenital hypotonia
1164:Meconium peritonitis
966:Intrauterine hypoxia
922:Subgaleal hemorrhage
351:Abrahams, P (2002).
204:Occupational therapy
163:flexor carpi ulnaris
119:Erb-Duchenne's palsy
1359:Neonatal withdrawal
1342:Perinatal mortality
1192:Sclerema neonatorum
1048:hematologic disease
567:Merritt's neurology
66:Klumpke's paralysis
22:Klumpke's paralysis
1292:mycoplasma hominis
1277:Neonatal infection
1233:Gray baby syndrome
1210:Perinatal asphyxia
1100:Hyperbilirubinemia
877:Postterm pregnancy
724:labour or delivery
596:2007-09-30 at the
159:hypothenar muscles
84:Signs and symptoms
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1110:Neonatal jaundice
1028:Pneumopericardium
998:Pneumomediastinum
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917:Caput succedaneum
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720:Maternal factors
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576:978-0-7817-9186-1
543:978-0-8016-3227-3
509:10.1002/mus.20960
462:"Klumpke's Palsy"
362:978-1-85605-699-1
336:978-0-06-046694-7
107:Horner's syndrome
63:
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16:Medical condition
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1352:Infant mortality
1187:Erythema toxicum
1179:thermoregulation
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834:Breech birth
824:presentation
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469:. Retrieved
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399:Neurosurgery
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285:(6): 585–7.
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97:, and C8/T1
95:hand muscles
87:
65:
64:
1337:Miscarriage
1239:muscle tone
1105:Kernicterus
958:Respiratory
934:Erb's palsy
839:Asynclitism
807:Nuchal cord
548:pp.576, 667
237:Erb's palsy
178:Erb's palsy
27:Other names
1347:Stillbirth
1304:Omphalitis
1265:Infections
1174:Integument
660:DiseasesDB
341:pp.370-374
243:References
174:childbirth
151:interossei
1073:Anti-Kell
711:period /
709:perinatal
279:Clin Anat
195:Treatment
184:Diagnosis
99:Dermatome
91:paralysis
58:Neurology
53:Specialty
1379:Category
1043:Bleeding
734:placenta
594:Archived
517:18236458
471:12 March
435:synd/335
421:18797367
367:pp.76-77
299:17330887
232:Dystocia
226:See also
1282:rubella
912:Chignon
766:chorion
451:739-90.
109:, with
857:Growth
770:amnion
573:
540:
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419:
359:
333:
297:
267:p.1046
155:thenar
115:miosis
113:, and
111:ptosis
1330:Other
1154:Ileus
901:scalp
654:767.6
639:P14.1
133:Cause
70:palsy
1088:Rh E
1083:Rh D
1078:Rh c
665:7200
649:9-CM
571:ISBN
563:in:
538:ISBN
513:PMID
473:2023
417:PMID
357:ISBN
331:ISBN
295:PMID
157:and
147:(T1)
125:and
1176:and
1068:ABO
1063:HDN
1045:and
645:ICD
630:ICD
505:doi
438:at
407:doi
287:doi
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372:^
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251:^
153:,
143:C8
129:.
127:C6
123:C5
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