Written by Trevor Ward, Birth Injury Unit Specialist

The anatomy of Erbs Palsy and Klumpke’s Palsy

The arm and shoulder contain a network of nerves known as the brachial plexus network. It is through this network that signals are sent from the spinal cord to your shoulders, arms, hands and fingers. As you might imagine, your hands and fingers have some of the most concentrated areas for nerve endings within your body. This helps you with functions such as movement and sensation.

These nerves are strong; however, they are not immune to injury. Damage to the brachial plexus network is most common with newborn babies and during childbirth, and this nerve damage occurs when the head, shoulder, neck or arm of the child is stretched or improperly manipulated. It is as a result of this nerve damage, that conditions such as Erb’s and Klumpke’s Palsy can develop.

What is Erb’s Palsy?

Erb’s Palsy is a condition that may occur when there is a partial injury to the brachial plexus network within the upper arm. Research suggests that the condition affects between 1-2 babies per 1000 births.

In most cases, the condition affects the shoulder, arm and elbow. Although the rest of the arm is likely to be affected, hands tend not to be affected, although you may experience tingling and numbness from time to time.

The main symptoms of Erb’s Palsy include:

• Paralysis or limpness with the shoulder, arm and/or elbow
• The palm of the hand points backwards. This is sometimes referred to as the ‘waiters tip position’
• You experience numbness or tingling in your hand

Due to where the nerve network is damaged, someone who suffers from Erb’s Palsy is likely to have trouble operating and controlling movement of their arm, which can include their shoulder and upper bicep. People who suffer with this condition are also likely to experience a decrease in muscle tone.

What is Klumpke’s Palsy?

Klumpke’s Palsy is again caused by an injury to the brachial plexus network of nerves that run through the arm from the spinal cord. It is most likely to affect the forearm, wrist, and hands.

The condition can be caused in the following ways according to Baptist Health:

• Difficult vaginal childbirth
• Tumour of the lungs or shoulder
• Trauma to the arms or shoulder

It is here where the nerve network may be stretched or torn, which can cause weakness, pain and numbness.

According to Cerebral Palsy Guidance, symptoms of Klumpke’s Palsy include:

• Experience of limpness in the lower arm, with minimal arm and hand movement
• Suffering from poor reflexes
• Experience of sensory loss
• Paralysis
• Stiffness in joints
• Suffering pain
• Muscle weakness
• A symptom known as ‘claw hand’, with a tightened hand and fingers

As this condition affects the forearm and hands, it is likely that someone with the condition experiences a decrease in muscle tone within this area. They may also experience a loss of dexterity within their fingers, which could impact their ability to write, type or to button a shirt.

Erb’s vs Klumpke’s Palsy

Although both conditions are caused in similar circumstances and are developed as a result of injuries to the brachial plexus nerve network, there is a slight difference between the two conditions.

As outlined above both conditions affect the arm and the functionality of the arm, however Erb’s Palsy affect the upper part of the arm which includes the shoulder, upper bicep and elbow. Klumpke’s Palsy, however, affects the lower part of the arm; including the forearm, wrists, hands and fingers.

Have you suffered negligence relating to Erb’s Palsy?

As medical negligence experts, we have many years’ experience handling cases in relation to Erb’s Palsy and birth injury. If you believe you or your child has been affected by negligence relating to Erb’s Palsy, our specialists are here to help.