KLUMPKE PALSY

Course overview

KLUMPKE PALSY, NAMED AFTER AUGUSTA DEJERINE-KLUMPKE, IS A NEUROPATHY INVOLVING THE LOWER BRACHIAL PLEXUS. IN CONTRAST, THE MORE COMMON; THE DUCHENNE PALSY INVOLVES THE MORE CEPHALIC PORTION OF THE BRACHIAL PLEXUS C5 TO C6. THE BRACHIAL PLEXUS IS A BUNDLE OF INDIVIDUAL NERVES THAT EXIT BETWEEN THE ANTERIOR AND MIDDLE SCALENE MUSCLES IN THE ANTERIOR LATERAL AND BASAL PORTION OF THE NECK. ALTHOUGH, THE MOST COMMON ANATOMICAL PRESENTATION OF THE BRACHIAL PLEXUS IS BETWEEN THE ANTERIOR AND MIDDLE SCALENE THERE ARE VARIATIONS WITH THE MOST COMMON BEING PENETRATION OF THE ANTERIOR SCALENE. THE MAIN MECHANISM OF INJURY TO THE LOWER BRACHIAL PLEXUS IS HYPER-ABDUCTION TRACTION AND DEPENDING ON THE INTENSITY, IT WILL LEAD TO SIGNS AND SYMPTOMS CONSISTENT WITH A NEUROLOGICAL INSULT.