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Paralysis: Basic Info

A paralysis usually refers to the inability to move various body parts such as arms and legs.

The possible causes are manifold and range from injuries to infections to strokes.

The type and severity of the symptoms depend on the extent and location of the nerve damage. The treatment depends on the underlying trigger.

Causes Symptoms Diagnosis Therapy & Course

The spinal cord plays a crucial role in the functioning of the body.

It forms the central nervous system (CNS) together with the brain.

The spinal cord runs in the so-called spinal canal within the spine and extends from above the first cervical vertebra to the level of the second lumbar vertebrae.

 It works like a conduit that transmits stimuli from the brain to the muscles and plays back information such as limb position, temperature sensation or pain from the muscles to the brain. 

If this nerve cable is damaged, it can lead to paralysis, disorders of autonomic functions and changes in muscle tension and reflexes.

In addition, paralysis may also be due to damage to peripheral nerves located outside the CNS.

Causes

Paralysis can be caused by a variety of factors, such as:
Injuries (e.g., craniocerebral injury, spinal cord injury due to vertebral fracture),
Disc prolapse,
Polyneuropathy (e.g., in diabetes or alcoholism),
Facial paralysis (facial palsy),
Migraine,
Inflammation of the meninges and brain,
Stroke,
Arteriosclerosis,
Circulatory disorders,
peripheral arterial disease (PAD),
Tumors in the brain and spinal cord,
Infections (e.g., diphtheria, Lyme disease, polio, botulism, Creutzfeldt-Jakob disease);
Muscular and nervous disorders (e.g., amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease).

Symptoms

Depending on the extent of the following types of paralysis are distinguished:

Paresis: mild to moderate paralysis.

Paralysis or plegia: complete paralysis, in which no muscle contractions can be detected. The literature occasionally selects a more detailed definition. 

Thus, in paralysis, muscles are generally affected, e.g. those of blood vessels or of the intestine, with a Plegie, however, exclusively the skeletal muscles.

Depending on the spread of the paralysis, the following distinctions are made in parlegia, paralysis, and paresis: The prefix "hemi" refers to one half of the body, "para" to both legs, and "tetra" to all four extremities.

Depending on the affected region, movements, gestures, and body mechanisms are no longer unconsciously or consciously controllable (e.g., walking, running, laughing).

Paralyzes can occur suddenly (for example, after an accident or stroke) or progress slowly (for example, in muscle and nerve disorders).

Diagnosis

The diagnosis is based on a detailed medical history and physical and neurological examinations.

Thereby u.a. Mobility, muscle strength, reflexes and sensations tested. 

Depending on the result or suspected diagnosis, the blood laboratory and imaging procedures, such as Computed tomography, magnetic resonance imaging, electromyography, electroneurography and electroencephalography. Optionally, u.a. CSF, muscle biopsy or genetic testing may be needed.

In addition to the distribution pattern, the type of paralysis can provide clues to the location of the injury:

Spastic paralysis is associated with increased muscle tone and indicates damage to the central nervous system (CNS).

Sagging paralysis occurs when damage is caused by peripheral, i. Nerves located outside of the spinal cord interfere with the connection between brain and musculature or are completely interrupted.

Therapy & course

The treatment depends on the underlying cause.
In case of infectious paralyzes antibiotics or antivirals may be used.
Paralyzes caused by brain tumors may regress after surgical treatment, chemotherapy or radiotherapy.

In cases of paralysis caused by accidents, an operation can be used to rescue the nerve connections.

In paralyzes in the context of muscle and nervous diseases are v.a. Supportive measures such as physiotherapy and physical treatments make sense to strengthen musculature, blood circulation and mobility. 

The main goal is to slow down the progression of the disease as much as possible.