Question:
What are the roots involved in an inferior brachial plexus lesion?
Answer:
C8 and T1
What is the result of injury to the nerve roots of C8 and T1?
Paralysis of the intrinsic muscles of the hands and flexors of the wrist leads to the classic "claw hand". Metocarpophalangeal joints are extended and interphalangeal joints are flexed due to unopposed reciprocal muscles.
It also results in paraesthesia over C8/T1 dermatome distribution
What other signs may be seen in Klumpke's paralysis?
Klumpke's paralysis is commonly associated with Horner's syndrome as traumatic injury to the lower nerve roots of the brachial plexus can also result in disruption to the sympathetic chain.
What is the most common cause of Klumpke's paralysis?
- Childbirth - pulling on arm during delivery
- Forceful, sudden extension of the arm above the head (like a monkey swinging on a tree!)
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