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diagram of Klumpke's palsy
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Klumpke's palsy.  Lower brachial plexus lesions involve C8 and T1. They are the result of traction on the arm in an abducted position - e.g. during a difficult labour; or at birth - Dejerine Klumpke's palsy.  The patient presents with a claw hand - the result of paralysis of the intrinsic hand muscles; sensory loss along the ulnar side of the hand and the forearm (first thoracic dermatome); and if the T1 root is affected, possibly, a Horner's syndrome from interruption of sympathetic innervation at that level.