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Erb's palsy and klumpke's palsy Animation - Etiology, Clinical manifestations, Diagnosis, Treatment
Erb's palsy or Erb-Duchenne palsy
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Erb's palsy or Erb-Duchenne palsy is a form of obstetric brachial plexus palsy. It occurs when there's an injury to the brachial plexus, specifically the upper brachial plexus at birth. The injury can either stretch, rupture or avulse the roots of the plexus from the spinal cord. It is the most common birth-related brachial plexus injury (50- 60%).
It is a lesion of C5 & C6 nerve roots (in some cases C7 is involved as well) usually produced by widening of the head shoulder interval. Injuries to the brachial plexus affects movement and cutaneous sensations in the upper limb. Depending on the severity of the injury, the paralysis can either resolve on its own over a period of months, require rehabilitative therapy or surgery.
Klumpke's Paralysis
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Klumpke paralysis is a neuropathy of the lower brachial plexus which may be resulted from a difficult delivery. Usually, the eighth cervical and first thoracic nerves are injured either before or after they have joined to form the lower trunk. This injury can cause a stretching (neuropraxia,), tearing (called “avulsion” when the tear is at the spine, and “rupture” when it is not), or scarring (neuroma) of the brachial plexus nerves. Most infants with Klumpke paralysis have a more mild form of injury (neuropraxia) and often recover within 6 months.
The main mechanism of injury is hyper-abduction traction and depending on the intensity, cause signs and symptoms consistent with a neurological insult.
According to the National Institute of Neural Disorders and Stroke (NINDS), there are four types of brachial plexus injuries that cause Klumpke’s :
Avulsion, in which the nerve is severed from the spine.
Rupture, in which tearing of the nerve occurs but not at the spine.
Neuroma, in which the injured nerve has healed but can’t transmit nervous signals to the arm or hand muscles because scar tissue has formed and puts pressure on it.
Neuropraxia or stretching, in which the nerve has suffered damage but is not torn.
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22 авг 2024