WHAT IS KLUMPKE'S PARALYSIS ??

IT IS A CONDITION THAT OCCURS BECAUSE OF THE INJURY IN THE LOWER TRUNK OF THE BRACHIAL PLEXUS (GROUP OF NERVES EMERGING FROM YOUR LOWER CERVICAL AND FIRST THORACIC NERVE)

THE LOWER TRUNK IS FORMED BY A UNION OF THE C8 AND T1 NERVE, SO THE NERVE INVOLVED ARE MAINLY C8 AND PARTLY T1

CAUSE OF INJURY

EXCESSIVE UNDUE/IMPROPER STRETCHING OF YOUR ARM CAN CAUSE EXCESSIVE ABDUCTION IN THE ARM

THERE MAY BE SOME BIRTH DEFECT THAT CAN CAUSE KLUMPKE'S PARALYSIS

CLUTCHING SOMETHING WITH THE HANDS AFTER A FALL FROM A HEIGHT CAN ALSO CAUSE KLUMPKE'S PARALYSIS

NAME THE MUSCLE PARALYSED

SINCE THE BRACHES OF THE LOWER TRUNK SUPPLY, THE LOWER PART OF THE UPPER EXTREMITY THUS MUSCLE PARALYSED INCLUDES THE INTRINSIC MUSCLE OF THE HAND, WHICH ARE SUPPLIED BY THE T1 NERVE, AND THE ULNAR FLEXORS OF THE HAND AND WRIST, WHICH ARE SUPPLIED BY THE C8 NERVE

DEFORMITY

THE DEFORMITY OF KLUMPKE'S PARALYSIS IS KNOWN AS THE CLAW HAND

CLAW HAND DUE TO THE UNOPPOSED ACTION OF THE LONG FLEXORS AND EXTENSORS OF THE FINGERS

CLAW HAND IS HYPEREXTENSION AT THE METACARPOPHALANGEAL JOINT (JOINT PRESENT BETWEEN METACARPALS AND PHALANGES) AND FLEXION AT THE INTERPHALANGEAL JOINT (JOINT PRESENT BETWEEN THE PHALANGES)

PERSON WITH CLAW HAND CANNOT PERFORM PROPER FUNCTIONING OF THE HAND

THEY ARE UNABLE TO HOLD, WRITE PROPERLY

DISABILITY

1) HORNER'S SYNDROME: IF YOUR T1 IS INJURED NEAR THE WHITE RAMI COMMUNICATIONS OF THE SYMPATHETIC GANGLION, THERE ARE HIGH CHANCES YOU MAY SUFFER THROUGH HORNER'S SYNDROME

HORNERS SYNDROME IS RELATED TO YOUR EYES

IT INCLUDES :

Ø PTOSIS (DROOPING EYES)

Ø MIOSIS (EXCESSIVE CONSTRICTION OF THE PUPIL OF THE EYE)

Ø ANHYDROSIS (ABSENCE OF SWEAT GLANDS)

Ø ENOPHTHALMOS (POSTERIOR DISPLACEMENT OF THE EYE)

Ø LOSS OF CILIO-SPINAL REFLEX (RAPID DILATION OF THE IPSILATERAL PUPIL WITH A PAINFUL STIMULUS ) IT DILATES ABOUT 1-2 MM FROM THE BASELINE

THIS SYNDROME OCCURS BECAUSE OF INJURY TO SYMPATHETIC FIBRES TO THE HEAD AND NECK THAT LEAVE THE SPINAL CORD THROUGH NERVE T1.

2) COMPLETE CLAW HAND: CLAW HAND IS MORE COMMON IN KLUMPKE'S PARALYSIS THAN COMPLETE CLAW HAND, BUT THERE ARE CHANCES THAT BOTH THE ULNAR AND THE MEDIAN NERVE GETS INJURED, AND THAT CASES RESULTS IN COMPLETE CLAW HAND

THE DIFFICULTIES IN BOTH THE CASES ARE SAME

3) CUTANEOUS CHANGES: CUTANEOUS ANAESTHESIA AND ANALGESIA IN A NARROW
ZONE ALONG THE ULNAR BORDER OF THE FOREARM AND HAND

4) VASOMOTOR CHANGES: THE SKIN AREA WITH SENSORY LOSS IS WARMER DUE TO ARTERIOLAR DILATION (WIDENING OF BLOOD VESSELS, USUALLY NEAR THE SURFACE OF SKIN, LEADING TO INCREASED BLOOD FLOW WITH FLUSHING OR WARMTH) ALSO, SINCE THERE IS LOSS OF SMYPHATHETIC ACTIVITY, THERE IS ABSENCE OF SWEATING THE SKIN AREA SUPPLIED BY C8, AND T1 NERVE ARE DRIER

5) TROPHIC CHANGES: LONG-STANDING CASES OF PARALYSIS LEADS TO DRY AND SCALY SKIN. THE NAILS CRACK EASILY WITH ATROPHY OF THE PULP OF FINGERS.

TREATMENT :

DEFECT DISCOVERED AT THE EARLY STAGES HELPS FOR THE TREATMENT MOST BABIES GENERALLY RECOVER COMPLETELY

IN MINOR DEFECTS, GENTLE MASSAGE OF THE ARM AND RANGE-OF-MOTION EXERCISES MAY BE RECOMMENDED

IN MAJOR DEFECTS THAT INCLUDES TURNING OF NERVE SURGERY CAN BE HELPFUL, BUT IT DEPENDS ON THE SEVERITY ALTHOUGH SURGERY BRINGS ABOUT GREAT CHANGES

THANK YOU

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