Klumpke’s Palsy Negligence Claims.

The symptoms of Klumpke’s palsy can range in intensity from mild and relatively subtle, to severe and more obvious to identify. In the vast majority of cases it is the right arm and hand which are most likely to be affected, although the condition can also affect the left very occasionally.

Babies and children suffering with Klumpke’s palsy will likely present with some combination of the following symptoms:

• Muscular atrophy in the forearm and/or hand
• Muscular weakness in the affected arm and/or hand
• Limited range of motion in the arm
• “Claw hand” where the wrist and fingers are constantly tightened
• Paralysis or limpness in the arm and/or hand
• Joint stiffness in the wrist and hand
• Numbness or pain in the affected arm and/or hand
• Babies may cry constantly due to the pain
• Horner’s syndrome which is the drooping of one eyelid

If your baby or child is displaying any of these symptoms we would advise you to seek medical help as soon as possible, especially if the birth was difficult or traumatic. Please don’t hesitate to get in touch with our team of specialist medical negligence solicitors who will be happy to advise you with regards to making a potential clinical negligence claim.

Klumpke’s palsy is most commonly caused by traumatic labour and a difficult vaginal delivery, for example if the baby is pulled out of the birth canal by their extended arm, or if their head and neck are pulled to the side awkwardly while their shoulders pass through the birth canal. These types of occurrences during childbirth could result in a brachial plexus injury, and they are often preventable.

There are a number of risk factors which may increase the likelihood of a traumatic labour, thus increasing the likelihood of a childbirth injury, including:

• Mothers over the age of 35
• A particularly petite mother
• Gestational diabetes
• Pelvic abnormalities
• Substantial antenatal weight gain
• Previous birth which led to Klumpke’s palsy
• Baby born in breech position
• Induced labour
• Improper use of assisted delivery tools like forceps
• Overdue pregnancy
• Difficulties with vaginal birth
• Prolonged time spent in active labour
• A large baby who is too big for the birth canal

If your baby has developed Klumpke’s palsy as a direct result of negligent care during pregnancy and childbirth, you may be able to claim compensation. Here at Lanyon Bowdler, our friendly and knowledgeable team of medical negligence lawyers are ready to help and support you.

In order to diagnose Klumpke’s palsy, a doctor will usually perform a physical examination, and they may also order various additional tests to further support the diagnosis, including:

• Electromyogram (EMG) – This is a test to measure the electrical activity of a muscle as it responds to a stimulus and can verify the presence and severity of nerve damage.
• Imaging studies – This could be any type of test which provides an internal image of the arm, wrist, and hand, such as an X-ray, MRI, CT scan, or ultrasound, in order to assess the damage to the bones and joints.
• Nerve conduction studies – The aim of these tests is to assess the effectiveness of an individual nerve in sending electrical signals between the spinal cord and the muscles.

Once a diagnosis of Klumpke’s palsy has been made, treatment can begin straight away. In many cases it is possible for babies to make a full recovery from the condition, and early treatment and intervention is the best way to avoid potential permanent joint and muscular contractions and paralysis.

In milder cases of Klumpke’s palsy it may be possible for the infant to recover fully and regain normal function of their arm without treatment. However, in most cases it will be necessary for medical intervention in order to prevent life-long problems with the affected arm, wrist, or hand.

The treatment options available will vary depending on the severity of the Klumpke’s palsy, but may include a selection of the following:

• Physiotherapy – Daily exercises can be effective in improving the range of motion in the affected arm, preventing stiffening, and promoting healing.
• Medication – Klumpke’s palsy may cause pain or a burning sensation so a doctor may prescribe oral medication or topical ointments to treat the pain.
• Muscle transfer – This involves the removal of a muscle or tendon from elsewhere in the body, and then attaching it to the affected arm in the event that the arm muscle has deteriorated.
• Nerve transfer – This involves a surgeon transferring a nerve from a different muscle to the affected arm in order to restore its nerve function.
• Nerve graft – In cases where the nerve has ruptured, it may be possible to repair it by splicing it with a separate nerve.
• Rehabilitation – Nerves recover very slowly and it may be several months or even years for the repaired nerves to affect the lower arm and hand, so post-surgery rehabilitation exercises can help to improve your child’s range of motion and build their strength.

In some cases, the treatment your child requires may not be available on the NHS, or you may receive much quicker treatment by paying for private medical care. If your child’s Klumpke’s palsy was a result of medical negligence, we can help you to claim the necessary compensation to help with the financial impact of caring for your child.

In mild cases of Klumpke’s palsy it is not uncommon for children to make a full recovery. According to the Genetic and Rare Diseases Information Centre (GARD) up to 88% of infants recover by the age of four months, and 92% recover by 12 months.

Infants with moderate Klumpke’s palsy may experience symptoms such as loss of sensation, arm limpness, a claw hand, joint stiffness, and severe pain in the affected arm as they grow. In cases of substantial nerve damage, it is possible for children to end up completely paralysed in the affected arm, and they are at increased risk of Horner’s Syndrome, which typically results in the drooping of the eyelid and anhidrosis (the inability to sweat) on one side of the face.

Klumpke’s palsy and Erb’s palsy are both forms of brachial plexus palsy, although of the two conditions, Klumpke’s palsy is rarer. The key difference between the two, however, is that Erb’s palsy affects the upper arm and shoulder, and Klumpke’s palsy affects the lower arm, wrist, and hand. In some cases, it is possible for an infant to experience damage to both the upper and lower nerves, affecting the movement in their shoulders, arms, and hands; this is known as total plexus involvement.