Catastrophic Injury

What is the Difference Between Erb’s Palsy (Brachial plexus palsy) and Klumpke’s Palsy?

Erb’s palsy (brachial plexus palsy) and Klumpke’s palsy are two specific types of brachial plexus injuries that impact different regions of the upper limb due to damage to different parts of the brachial plexus. The brachial plexus is a network of nerves that extends from the spinal cord through the neck and into the arm, controlling movement and sensation in the shoulder, arm, forearm, and hand. When this complex network is damaged, it can lead to varying degrees of motor dysfunction and sensory loss, depending on the location of the injury.

Understanding the Brachial Plexus network

The brachial plexus is divided into five primary nerve roots: C5, C6, C7, C8, and T1. These nerve roots branch out into various sections of the muscles and skin of the upper limbs. The injuries that cause brachial plexus palsy (Erb’s palsy), and Klumpke’s palsy involve different parts of this nerve network. While Erb’s palsy primarily involves injury to the upper part of the brachial plexus (C5 and C6), Klumpke’s palsy involves damage to the lower portion (C8 and T1).

What is Erb’s Palsy (Brachial plexus palsy)?

Erb’s palsy (also called Erb-Duchenne Palsy) is caused by damage to the upper brachial plexus, affecting the C5 and C6 nerves. These nerves are responsible for controlling movement in the shoulder and upper arm, particularly the deltoid, biceps, and brachialis muscles. When these nerves are injured, the corresponding muscles lose functionality, leading to weakness or paralysis in the upper arm and shoulder.

Erb’s palsy (brachial plexus palsy) most commonly occurs during childbirth when excessive stretching or traction is carelessly applied to the baby’s neck and head, often during difficult deliveries. Some common causes include:

  • Shoulder dystocia: A situation where the baby’s shoulder becomes lodged behind the mother’s pubic bone, leading to traction on the brachial plexus.
  • Breech deliveries: In cases of breech births, where the baby is delivered feet or buttocks first, the arms can be stretched upwards, putting pressure on the upper brachial plexus.
  • Birth-assistive devices: Improper use of forceps or vacuum extraction during delivery can also cause traction and injury to the brachial plexus.

The symptoms of Erb’s palsy (brachial plexus palsy) are related to the paralysis or weakness of the shoulder and upper arm muscles. Typical clinical signs include:

Weakness or complete paralysis in the shoulder and upper arm.
A type of deformity where the arm hangs limp by the side, internally rotated, with the forearm pronated and the wrist flexed.
Limited shoulder movement where the child may be unable to lift the arm away from the body (abduction) or rotate the arm externally.
Loss of sensation: In severe cases, there may also be sensory loss in the areas innervated by C5 and C6 nerves.

The treatment for Erb’s palsy (brachial plexus palsy) depends on the severity of the injury. Some treatment options include physical therapy, occupational therapy and surgical intervention.

What is Klumpke’s Palsy?

Klumpke’s palsy (also known as Klumpke-Dejerine Palsy) involves injury to the lower brachial plexus, particularly the C8 and T1 nerves. These nerves primarily control movement in the forearm, wrist, and hand. When damaged, the muscles in these areas become weak or paralyzed, leading to distinct impairments compared to Erb’s palsy (brachial plexus palsy).

Similar to Erb’s palsy (brachial plexus palsy), Klumpke’s palsy can result from traumatic childbirth or other trauma that affects the lower brachial plexus. One common cause, for example, is breech delivery where the infant’s arm is stretched upward during a breech birth, it can lead to damage to the lower brachial plexus.

Klumpke’s palsy presents with a distinct set of symptoms that primarily affect the lower arm, wrist, and hand:

Paralysis or weakness in the forearm, wrist, and hand muscles.
Claw hand deformity: This is characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, creating a claw-like appearance of the hand.
Loss of fine motor control: The patient may have difficulty grasping or holding objects due to weakness in the hand muscles.
Sensory loss: In some cases, there may also be numbness or tingling in the hand and forearm.

As with Erb’s palsy (brachial plexus palsy), the treatment for Klumpke’s Palsy depends on the severity of the nerve injury. Treatment options include physical therapy and surgical repair where nerves have been severely injured or damaged. A hand splint may also be used to prevent contractures and improve the functional positioning of the hand.

Contacting an Experienced Lawyer

The costs of caring for a child with brachial plexus palsy (Erb’s palsy) or Klumpke’s palsy can add up very quickly. If your child’s injury was caused by medical negligence (carelessness), you may be able to seek compensation for damages including loss of earnings, medical expenses, cost of hospitalization, ongoing treatment and therapies, psychological counseling, permanent injuries, disabilities, past and future pain and suffering, etc.

The experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you. One of our clients secured a $2,850,000 verdict that was reduced by the appeals court to $1,846,000 because the verdict was so large. This was the highest amount upheld by the appellate (appeals) courts for many, many years. In addition we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head. Also, one of our clients obtained a verdict for $43,940,000 and another of our clients got a verdict for $23,500,000, both in medical malpractice cases.

We have seen cases where New York City Health and Hospital Corporation facilities deliver babies who are born with brachial plexus palsy (Erb’s palsy) stemming from negligence (carelessness), and/or medical malpractice in the labor and delivery etc. of the children.

The following list identifies some of these hospitals (operated by New York City Health and Hospitals Corporation):

• Jacobi Hospital aka Bronx Municipal 1400 Pelham Parkway South Bronx, New York 10461 718-918-5000
• Lincoln Hospital 234 East 149th Street Bronx, New York 10451 718-579-5000
• North Central Bronx Hospital 3424 Kossuth Avenue Bronx, New York 10467 718-519-5000
• Coney Island Hospital 2601 Ocean Parkway Brooklyn, New York 11235 718-616-3000
• Kings County Hospital 451 Clarkson Avenue Brooklyn, New York 11203 718-245-3131
• Woodhull Hospital 760 Broadway Brooklyn, New York 11206 718-963-8000
• Bellevue Hospital 462 First Avenue New York, New York 10016 212-562-5555
• Harlem Hospital 506 Lenox Avenue New York, New York 10037 212-939-1000
• Metropolitan Hospital 1901 First Avenue New York, New York 10029 212-423-6262
• Elmhurst Hospital 79-01 Broadway Elmhurst, New York 11373 718-334-4000
• Queens Hospital Center 82-68 164th Street Jamaica, New York 11432 718-883-3000

Please contact us TOLL FREE 24 hours a day, 7 days a week at 1-800-WORK-4-YOU (1-800-967-5496). WE CAN EVEN COME TO YOU. There is no attorneys’ fee unless we recover money for you. We can also help with personal injury, lead poisoning and medical malpractice cases including, brachial plexus palsy (Erb’s palsy) and cerebral palsy cases in New York, New Jersey, Connecticut, Pennsylvania, or Florida. If you have been seriously injured in any of the 50 U.S. states, please call us and we will try to help you with your case.

Other TOLL FREE phone numbers for us are:

1-800-RADIO-LAW, 1-888-WYPADEK, OR 1-800-LAS-LEYES

Please visit us at: www.WORK4YOULAW.com

Published by
Ken Wilhelm