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Erb%u2019s Palsy vs. Klumpke'sPalsyFeature Erb's Palsy Klumpke's PalsyAffected Nerve Roots C5-C6 (sometimes C7) C8-T1Upper/Lower Plexus Upper brachial plexus Lower brachial plexusArm Position Arm adducted, internally rotated Minimal effect on upper armElbow Extended, pronated Minimal effectWrist Flexed ExtendedHand Minimal effect Clawed hand (intrinsic muscle paralysis)Characteristic Pose \\Shoulder Movement Impaired abduction and external rotation Usually unaffectedBiceps Reflex Absent or diminished PresentGrasp Reflex Present Absent or weakAssociated Signs Possible Horner's syndrome (rare) Possible Horner's syndrome (more common)Common Cause Shoulder dystocia during birth Forceful downward traction of armPrognosis Often better than Klumpke's Generally poorer than Erb's
