Isolated lower brachial plexus (Klumpke) palsy with compound arm presentation: case report

Area of Science:

• Neonatal neurology
• Pediatric neurology
• Obstetrics

Background:

• Klumpke palsy, an isolated lower brachial plexus palsy, lacks clear documentation in newborns.
• Previous reports often omit crucial obstetrical history, clinical progression, and outcome details.
• Hyperabduction of the arm during delivery is the presumed mechanism, often associated with breech presentations.

Observation:

• This report details a newborn with isolated lower brachial plexus palsy and Horner syndrome.
• The infant presented at birth with a vertex compound arm presentation.
• This presentation differs from the commonly presumed mechanism of Klumpke palsy.

Findings:

• The case demonstrates an isolated lower brachial plexus palsy and Horner syndrome.
• A vertex compound arm presentation at birth was observed.
• This challenges the traditional understanding of Klumpke palsy etiology.

Implications:

• Accurate documentation of neonatal brachial plexus injuries is crucial.
• Recognizing alternative presentations like vertex compound arm is important for diagnosis.
• Establishing clear management guidelines for Klumpke palsy is currently lacking and needed.