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Paralysis:
Symptoms, Causes, Risk Factors, Diagnosis & Treatment

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1.What is Paralysis?

Paralysis is the loss of muscle function in the body. Paralysis is sometimes temporary and in a few cases, it is permanent. Paralysis is not limited to any particular part of the body, but most cases of paralysis are observed in limbs. Partial and complete paralysis can occur at any point in time. A patient suffering from paralysis is not inflicted by any pain upon occurrence.

Depending on the nature of the underlying cause, the treatment plan is charted either to cure or to treat the condition to ensure that the daily lifestyle of the patient is not drastically affected.

A stroke is the most common underlying condition that triggers partial or complete paralysis in a patient. In partial paralysis, the patient is still in partial control of the affected muscle, incomplete paralysis, the patient has no control over the affected muscle tissue.

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2.Types of Paralysis

The most prominently known types of paralysis are:

  • Monoplegia
  • Hemiplegia
  • Paraplegia
  • Quadriplegia
  • Locked-in syndrome

Monoplegia:

Monoplegia is a type of paralysis where the person loses control over one limb. Often the paralysis is limited to a single-arm, sometimes even limited to certain muscles in an arm. Monoplegia is often the side effect of cerebral palsy. In cerebral palsy, the brain loses the ability to control certain muscles of the body. Infants and early adolescents are mostly affected by cerebral palsy.

Monoplegia is considered a good sign in the prognosis of this syndrome as the paralysis is limited to a single limb and the patient can still work around his daily activities with relative ease.

Hemiplegia:

Hemiplegia is a type of paralysis where a person loses control of one side of the body. The effect of this is generally limited to one arm and one limb and sometimes the effect is also seen in the torso region. Hemiparesis is a condition when the person does not lose the complete functionality of their limbs but their functionalities are significantly reduced in terms of strength and endurance. Hemiparesis evolves into hemiplegia in a few cases.

Hemiplegia is caused due to injuries to the spinal cord or when the left and right side of the brain are not communicating properly through the corpus callosum. Hemiplegia is also caused by a stroke, which affects the functioning of one side of the brain.

Hemiplegia is further divided into left hemiplegia and right hemiplegia. Depending on the location of the damage, right or left hemiplegia can be diagnosed.

Patients suffering from hemiplegia may find it difficult to speak and resume normal motor functions. They experience total or partial loss of sensation in one side of the body and this leads to Pusher’s syndrome where the patient shifts the weight of the paralysed side to the normal side, thereby adversely affecting motor functions.

The treatment option includes an array of blood thinners, antibiotics, surgery, anti-inflammatory drugs and exercise.

Paraplegia:

Paraplegia is a form of paralysis where the patient loses control over the muscles from the waist down. The effects of paraplegia vary from person to person. People going through paraplegia have perfectly healthy legs and the underlying cause of this condition mostly originates in the brain or spinal cord. Paraplegia is sometimes complete and sometimes only affects one limb in the lower torso. Partial paraplegia is often a result of consistent physiotherapy and medication.
Paraplegia is often caused after the patient experiences an injury in the brain, or the spinal cord or both. In paraplegic patients, the signals that are sent to the lower part of the body from the brain are not sent back up to the brain through the spinal cord. This lack of communication with the brain, causes the patients to not only lose motor functions but also results in loss of sensation.

In a few cases, serious injuries to the leg, an allergic reaction or side effects of seizure can exhibit the form of paraplegia. It is advised to take several days before confirming the diagnosis of paraplegia. MRI, CT scans, blood tests, and myelography X-rays can be used to test for paraplegia.

In partial or incomplete paraplegia, the patient can retain functionalities of a single leg while in complete paraplegia, the patient loses sensation and functionalities of both the legs. Car accidents, sports-related injuries, side effects to surgeries, spinal cord injuries, violence, and falls are the major causes of paraplegia.

This is also caused because of strokes, auto-immune diseases, genetic disorders, infections, tumours and disorders in the spinal cord.

Quadriplegia

A quadriplegia is a form of paralysis where all four limbs are affected. In this condition, the signals that are sent from the brain to the regions below the neck are not sent back, thereby causing impalement in the hands and legs of the patient. The spinal cord is charged with the job of sending signals to and receiving signals from the brain. In quadriplegia, this ceases to function, thereby causing the condition.
Injuries to the spinal cord or the brain can trigger the onset of quadriplegia. As the injuries to the affected area heal or when the inflammation in the brain decreases, the chances of recovering from this condition is possible. However, giving an accurate prognosis is not possible.

Patients suffering from quadriplegia experience fatigue, loss of sensation in the region below the neck, sudden spasms, difficulty in clearing urine from the body, respiratory distress, bedsores, and depression among other side effects.

The treatment for quadriplegia includes surgeries in the spinal cord and brain, anti-inflammatory drugs, antiviral drugs, exercise, physiotherapy, psychotherapy, speaking and listening therapy, and participating in support groups.

Locked-in Syndrome:

Locked-in Syndrome is a form of Paralysis where the patient is not able to control any part of their body from under the eyes. Locked-in syndrome is majorly a side-effect of a major injury to the brain or a stroke or cancer in the brain. A person affected by locked-in syndrome will not be able to move his lips, his jaws, no up & down or side to side moments in the neck or move any other limb of his body. However, people suffering from locked-in syndrome can blink and move their eyeballs up and down.

Locked-in syndrome often mimics the symptoms of a coma and doctors rely on the moment of the eyes to make a perfect diagnosis.

This disorder occurs when the middle part of the brain is injured/destroyed but the cerebrum and cerebellum, the parts of the brain that control consciousness and mental function, are left undamaged.

Providing good nutrition is imperative to ensure that the patient receives all the nutrients required. However, the patient has to be fed through a stomach tube that is either sent into the stomach from the nose or an incision is made in the small intestines and sent there directly.

Because of prolonged bed rest, patients often suffer from pressure sores, blood clots, muscle damage and nerve damage. Care should be taken to prevent pressure sores by moving the patient, massaging the muscles, moving the joints along its axis, and physiotherapy.

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3.Conditions that cause Paralysis

Paralysis Treatment

The prominent conditions that lead to paralysis are:

  • Acute Flaccid Myelitis
  • Amyotrophic Lateral Sclerosis
  • Brachial Plexus Injury
  • Brain Injury
  • Cerebral Palsy
  • Guillain-Barre Syndrome
  • Leukodystrophies
  • Lyme Disease
  • Multiple Sclerosis
  • Muscular Dystrophy
  • Neurofibromatosis
  • Post-Polio Syndrome
  • Spina Bifida
  • Stroke
  • Spinal Tumours
  • Brain Tumours
  • Spinal Cord Injury and
  • Transverse Myelitis

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4.Symptoms of Paralysis

Paralysis is sudden and is often a side effect of injury to the brain or spinal cord. Sometimes a stroke or cancerous cells pressing against the brain cells can also cause paralysis.

The most common symptoms of paralysis are spam, loss of sensation in arms and legs, reduced muscle function, reduced motor functions, and losing the ability to talk.

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5.Causes of Paralysis

Stroke is the most prominent cause of paralysis. More than 30% of the reported cases in the United States alone is from stroke and coming close to this is multiple sclerosis at 17%. Other causes of paralysis include cerebral palsy, post-polio syndrome, brain and spinal cord injuries, neurofibromatosis and conditions that are present by birth.

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6.Complications

While a few forms of paralysis let the patient continue to lead a normal life, there are a few that can cause severe complications. The dependence on crutches, wheelchairs, full-time nursing and a lot of other factors can increase significantly. The most common complications are chest pains, high blood pressure, and depression. Sex life and fertility are affected differently in men and women. In men, it becomes difficult for them to maintain a psychogenic erection as an erection stimulated by thoughts would require the nerves above the spine to send the signals. In high-level cases of partial paralysis and all the cases of complete paralysis, a psychogenic erection is not possible. However, the penis sometimes becomes erect in response to a touch, maintaining the erection for prolonged periods might be challenging.

In women, the sex drive does is not affected by partial or complete paralysis. However, few women might experience a reduced drive because of their appearance or having to use a bladder or bowel control system. In women, however, the vagina does not lubricate itself upon arousal as the nerves responsible for this are above T6. As an alternative, water-based lubricants like KY jelly can be used.

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7.Treatment

There is currently no cure to paralysis, however, there are multiple options available in terms of extensive care and mobility that could improve the lives of patients with partial paralysis.

Mobility:

Patients suffering from partial paralysis in the legs, with good upper body strength can use manual wheelchairs to commute short distances while people with less upper body strength can use electric wheelchairs.

Cars can also be retro-fitted to suit the needs of the specially-abled. The accelerator and brake pedals can be replaced with levers while the steering wheel can be customised to an extent where it can be manoeuvred using a wrist instead of relying on fingers to grip it.

Communication:

Patients suffering from quadriplegia can rely on voice-command-based systems for controlling things like light, temperature, TV, audio units, and telephones/mobile phones.

Patients suffering from locked-in syndrome can use specially adapted computers to make small sentences or improve the form of current communication.

Exercise and Physiotherapy:

Exercise and regular physiotherapy have seen positive results in patients suffering from partial or complete paralysis either in hands or legs. In a few cases, with exercise, patients have been successful in recovering sensation and motor functions in one of the two affected limbs.

Medication:

Depending on the nature of the condition, brain and spinal cord surgeries can help treat the condition by reducing the size of the swelling. In the treatment regime, the patient must continue the medication course without any hindrance as these medications help prevent any onset of viral or bacterial infections.

Paralysis in quadriplegia and locked-in syndrome causes respiratory distress. In such conditions, the patients can either choose to rely on non-invasive or invasive ventilators. This should be acted upon only after consulting a medical practitioner.

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8.Paralysis FAQs: All your concerns addressed

Q.  What is Paralysis?

  1. Paralysis is a condition where the muscles of a certain body part lose sensation and its functions. Paralysis is often a side effect of a stroke or a cancerous tumour pressing against the brain or spinal cord. In most cases though, it is also when the body sustain serious injuries to the back of the brain.

Q.  What is the life expectancy of a person suffering from quadriplegia?

  1. Earlier, the life expectancy of a patient with Paralysis was 29, however, this has come up to 42. Most patients are still able to drive to work, use alternatives and depend on crutches and wheelchairs to resume normal day to day activities.

Q.  Can paralysis be prevented?

  1. Paralysis that is caused in early childhood as a side effect of a polio infection can be avoided by getting the baby vaccinated. That said, the other forms of paralysis are mostly as a side effect to a reaction happening in the brain or spinal cord.

Q.  What are the secondary effects of paralysis?

  1. The secondary side effects of paralysis are depression, reduced sex drive, complications in conceiving, respiratory distress, muscle weakness, nerve damage, joint pains, inflammation in the skin, severe headaches, and chest pains.

Q.  Is a person suffering from paralysis allowed to drive?

  1. Yes, however, a doctor must be consulted before beginning to drive again. With advancements in technology, now, cars and motorcycles can be modified to suit the needs of the specially-abled.

Q.  What is the main cause of paralysis?

  1. Paralysis is a loss of motor function in one or more muscles. There can be many causes for paralysis but is often caused by strokes, usually from a blocked artery in your neck or brain. Some other common causes are nerve injury, poliomyelitis, multiple sclerosis, cerebral palsy, Parkinson's disease, spina bifida, peripheral neuropathy, ALS, botulism, and Guillain–Barré syndrome. It can also be caused by spinal cord or brain damage during/after a car accident or sports injury. Other causes of paralysis:
    • Alternating Hemiplegia
    • Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)
    • Familial Periodic Paralysis
    • Hereditary Spastic Paraplegia
    • Medications
    • Muscular Dystrophy
    • Poisons/Toxins
    • Tick Paralysis
    • Todd's Paralysis
    • Trauma
    • Tumours

Q.  What are the early symptoms of paralysis?

  1. The symptoms of paralysis are usually easily identifiable. A tingling or numbing sensation occurs in the body part before the complete paralysis sets in. You’ll gradually lose function in a specific or widespread area of your body if you are experiencing paralysis. Some of the early symptoms are:
    • Changes in mood, personality or behaviour
    • Clumsiness
    • Confusion or loss of consciousness for even a brief moment
    • Difficulty with memory, thinking, talking, comprehension, writing or reading
    • Drooling
    • Numbness
    • Constipation
    • Diarrhoea
    • Fever
    • Hearing loss
    • Loss of vision or changes in vision
    • Nausea with or without vomiting
    • Neck pain
    • Rash
    • Severe headache

Q.  What are the 4 types of paralysis?

  1. Types of Paralysis:
  2. 1) Complete paralysis is a condition when you can't feel or move the paralyzed part of your body at all.

    2) Partial or incomplete paralysis is a condition when you have some control or feeling in the paralyzed parts. This condition is also called as paresis.

    3) When just one specific body part, like hands or legs, is paralyzed, it is termed as Localized paralysis.

    4) Generalized paralysis is much widespread in your body. This type of paralysis usually depends on where part of your brain or spinal cord is injured.

Q.  Can you die from paralysis?

  1. Being paralytic won’t kill you. It might aid in developing other medical problems like problems with blood flow, breathing, and heart rate; changes in the normal function of organs, glands, and other tissues; changes to muscles, joints, and bones; skin injuries and pressure sores; blood clots in the legs' loss of urine and bowel control; sexual problems; problems speaking or swallowing; or behaviour and mood changes.

Q.  How is paralysis diagnosed?

  1. Identifying and diagnosing an external paralysis is often easy as there's a clear loss of movement and muscle function in a body part. For internal parts, which is difficult to be detected with paralysis, technologies like X-rays, CT scans, MRI scans, or other imaging studies are applied. The treatment plan depends on the underlying cause and symptoms of paralysis. The doctor might prescribe:
    • surgery or possible amputation
    • physical therapy
    • occupational therapy
    • mobility aids, such as wheelchairs, braces, mobile scooters, or other devices
    • medications, such as Botox or muscle relaxers, if you have spastic paralysis
    • In many cases, paralysis isn’t curable. But a healthcare team can recommend a variety of treatments, tools, and strategies to help manage symptoms.

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9.Outlook and Prognosis

There are a few cases of paralysis in which the conditions can be reversed. However, in most cases the effects of paralysis are permanent.

People suffering from monoplegia, Paraplegia, hemiplegia can still take the aid of mobility devices, adaptive devices, and walking aid and try to resume their day 2-day life. Patients suffering from Quadriplegia and Locked-in syndrome will have to rely on complete care for their entire life. Lives of people with Quadriplegia can still be happy and fulfilling.

Exercise and physical activity must be inculcated into the new regime as much as possible regularly, this keeps the body healthy and fights depression.

Depression should be dealt with professionally. Seeking help from medical professionals, following the regime for antidepressants, and participating in support groups can help patients fight depression and make their way towards the road to recovery.

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