KLUMPKE’S PARALYSIS

INTRODUCTION:

• Klumpke’s palsy or Dejerine–Klumpke palsy is a variety of partial palsy of the lower roots of the brachial plexus.

SITE OF INJURY:

• Lower trunk of brachial plexus

ETIOLOGY:

Undue abduction of the arm, as in

• Clutching something in hands while falling from a height
• May be in birth injuries [forceful breech delivery]

AFFECTED ROOTS:

• Mainly T1, Partly C8

MUSCLES PARALYZED:

• Intrinsic muscles of the hand(T1)
• Ulnar flexors of the wrist and fingers(C8)

CLINICAL FINDINGS:

• Hyperextension at metacarpo – Phalangeal joint
• Flexion at inter – Phalangeal joint”
• “Claw Hand/’intrinsic minus HAND”
•  Cutaneous anesthesia and analgesia in a narrow zone along the ulnar border of fore – arm & hand
• Vasomotor changes skin areas with sensory loss is warmer due to arteriolar dilatation
• Trophic changes: Long standing paralysis leads to dry a scaly skin
• Cutaneous anesthesia and analgesia in a narrow zone along the ulnar border of fore – arm & hand
• Horner’s syndrome: Injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T1
• Vasomotor changes in skin areas with sensory loss is warmer & drier due to arteriolar dilatation
• Trophic changes:Long standing paralysis leads to dry a scaly skin