Klumpke’s palsy is a temporary affliction of the 7th and 8th cranial nerves, sometimes caused by pressure on the nerve from wearing tight clothes. The condition results in facial paralysis, which manifests in drooping of the lower eyelid (ptosis), inability to tear up (lacrimation), inability to raise eyebrows, and difficulty with facial expression; similar symptoms may occur for the tongue. The illness typically lasts about three months.
The condition results from a lesion on the 7th and/or 8th cranial nerves, which innervate the muscles of facial expression (the frontalis muscle) and tongue movement. The nerve is compressed or stretched where it passes through the capsule of the vertebral column below C1, at the level known as the C1 marker. The result is the motor paralysis of the affected muscle groups.
The name “Klumpke’s palsy” comes from an ophthalmologist, Josef Klumpke. The term is sometimes referred to as “C1-palsy”, based on being restricted to the nerve roots supplying the upper cervical region of the spinal cord.
It is the third most common cause of facial nerve paralysis; there are 120,000 new cases each year. It is most common in children and can be caused by various events, including genetic disorders, head trauma, and neck surgery. Up to two-thirds of cases are associated with inflammation or other nerve damage in the cervical spinal cord. The associated symptoms include poor vision, tics, tremors (“myokymia”), hearing loss, tinnitus, and vertigo. The condition is not contagious, and children should not be treated with antibiotics.
Many causes of Klumpke’s palsy are idiopathic – the cause of the paralysis cannot be identified. In such cases, it is called symptomatic Klumpke’s palsy or “Klumpke’s palsy (symptomatic).” Symptomatic Klumpke’s palsy may occur as a complication of neck trauma, surgery, inflammation, and malignancy in the cervical spine region. Trauma may result in spinal cord injury (SCI), intervertebral disc herniation (IDH), or cervical ribs.
Any process that causes inflammation of the cervical spinal cord, such as myelitis or meningitis, can result in symptomatic Klumpke’s palsy. The development of symptomatic Klumpke’s palsy is rare following viral infections such as herpes simplex virus and varicella-zoster virus.
Klumpke’s palsy may be associated with symptoms such as:
- Klumpke’s palsy develops most commonly in children and adolescents between 2–12 years. It is more common in boys, affecting twice as many males as females. The condition is most common between the ages of 9 and 12. Klumpke’s palsy may occur due to external pressure on the nerve, such as from wearing tight clothes, or it may already exist due to underlying pathology or injury (such as from a head or neck injury or intervertebral disc herniation).
- Klumpke’s palsy is diagnosed based on symptoms. A physician may conduct a physical examination and ask the patient to perform tests such as a cranial nerve examination. The physician may ask the patient to perform tasks involving facial expression (such as smiling), lip pursing, eye deviation, tongue protrusion, and facial strength. The motor examination also includes checking for the weakness of the temporalis muscle and facial nerve function.
- Klumpke’s palsy is classified as one of three types based on the characteristics of paralysis. Depending on the symptoms, patients may be diagnosed with type I (head trauma), type II (neck surgery), or type III (cervical spine injury); however, some cases are not clearly defined and may fall under multiple classification systems.
Klumpke’s palsy lawyer will create an individualized plan for each patient and family to help maximize their chance of recovery. The plan might involve physical therapy or surgery, but it always includes assistance in dealing with any insurance company. If the insurance company denies coverage or pays less than they owe you, an experienced Klumpke’s palsy lawyer will help you recover your benefits.
A Klumpke’s palsy lawyer understands that compensation is only part of the solution. Most patients with Klumpke’s palsy require some sort of surgery to repair damage to the fifth cranial nerve. The good news is that the surgery is usually not complicated. However, most surgeons will want to know exactly what happened to you in terms of your hobbies or past sports injuries, and they might ask you to provide a second opinion.
If you are already suffering from Klumpke’s palsy, the insurance company might help pay for the surgery. But they won’t pay for the follow-up care or your lost compensation while you are out of work. That is where a Klumpke’s palsy lawyer can help. Your attorney will negotiate down with the insurance company so that you receive the maximum amount of premium dollars to pay for your medical care, rehabilitation, and other losses. A determined Klumpke’s palsy lawyer will remain on the case until a full recovery is made.