Paraplegia Health Dictionary

Paralysis, or PALSY, is loss of muscular power due to some disorder of the NERVOUS SYSTEM. Weakness – rather than total movement loss – is sometimes described as paresis. Paralysis may be temporary or permanent and may be accompanied by loss of feeling.

Paralysis due to brain disease The most common form is unilateral palsy, or HEMIPLEGIA, generally arising from cerebral HAEMORRHAGE, THROMBOSIS or EMBOLISM affecting the opposite side of the BRAIN. If all four limbs and trunk are affected, the paralysis is called quadraplegia; if both legs and part of the trunk are affected, it is called paraplegia. Paralysis may also be divided into ?accid (?oppy limbs) or spastic (rigid).

In hemiplegia the cause may be an abscess, haemorrhage, thrombosis or TUMOUR in the brain. CEREBRAL PALSY or ENCEPHALITIS are other possible causes. Sometimes damage occurs in the parts of the nervous system responsible for the ?ne control of muscle movements: the cerebellum and basal ganglion are such areas, and lack of DOPAMINE in the latter causes PARKINSONISM.

Damage or injury Damage to or pressure on the SPINAL CORD may paralyse muscles supplied by nerves below the site of damage. A fractured spine or pressure from a tumour may have this e?ect. Disorders affecting the cord which can cause paralysis include osteoarthritis of the cervical vertebrae (see BONE, DISORDERS OF), MULTIPLE SCLEROSIS (MS), MYELITIS, POLIOMYELITIS and MENINGITIS. Vitamin B12 de?ciency (see APPENDIX 5: VITAMINS) may also cause deterioration in the spinal cord (see also SPINE AND SPINAL CORD, DISEASES AND INJURIES OF).

Neuropathies are a group of disorders, some inherited, that damage the peripheral nerves, thus affecting their ability to conduct electrical impulses. This, in turn, causes muscle weakness or paralysis. Among the causes of neuropathies are cancers, DIABETES MELLITUS, liver disease, and the toxic consequences of some drugs or metals – lead being one example.

Disorders of the muscles themselves – for example, muscular dystrophy (see MUSCLES, DISORDERS OF – Myopathy) – can disturb their normal working and so cause partial or complete paralysis of the part(s) affected.

Treatment The aim of treatment should be to remedy the underlying cause – for example, surgical removal of a displaced intervertebral

disc or treating diabetes mellitus. Sometimes the cause cannot be recti?ed but, whether treatable or not, physiotherapy is essential to prevent joints from seizing up and to try to maintain some tone in muscles that may be only partly affected. With temporary paralysis, such as can occur after a STROKE, physiotherapy can retrain the sufferers to use their muscles and joints to ensure mobility during and after recovery. Patients with permanent hemiplegia, paraplegia or quadraplegia need highly skilled nursing care, rehabilitative support and resources, and expert help to allow them, if possible, to live at home.... paralysis

(Roth) K. Schum.

Synonym: A. caryophyllata G. Don

Family: Apocynaceae.

Habitat: Assam, West Bengal, Bihar, Orissa, Andhra Pradesh and Tamil Nadu; often cultivated in Indian gardens.

Ayurvedic: Madhumaalati.

Action: Antiseptic; anodyne (an ingredient in massage oils for paraplegia, neuralgia, sciatica); also anthelmintic and emetic.

The leaves contain quercetin, kaem- pferol and phenolic acids. Shoot tips and flower buds contain tannin.

Aganosma calycina A. DC. is also equated with Madhumaalati.... aganosma dichotoma

The term used to describe a group of conditions characterised by varying degrees of paralysis and originating in infancy or early childhood. In some 80 per cent of cases this takes the form of spastic paralysis (muscle sti?ness), hence the now obsolete lay description of sufferers as ‘spastics’. The incidence is believed to be around 2 or 2·5 per 1,000 of the childhood community. In the majority of cases the abnormality dates from well before birth: among the factors are some genetic malformation of the brain, a congenital defect of the brain, or some adverse e?ect on the fetal brain as by infection during pregnancy. Among the factors during birth that may be responsible is prolonged lack of oxygen such as can occur during a di?cult labour; this may be the cause in up to 15 per cent of cases. In some 10–15 per cent of cases the condition is acquired after birth, when it may be due to KERNICTERUS, infection of the brain, cerebral thrombosis or embolism, or trauma. Acute illness in infancy, such as meningitis, may result in cerebral palsy.

The disease manifests itself in many ways. It may not be ?nally diagnosed and characterised until the infant is two years old, but may be apparent much earlier – even soon after birth. The child may be spastic or ?accid, or the slow, writhing involuntary movements known as athetosis may be the predominant feature. These involuntary movements often disappear during sleep and may be controlled, or even abolished, in some cases by training the child to relax. The paralysis varies tremendously. It may involve the limbs on one side of the body (hemiplegia), both lower limbs (paraplegia), or all four limbs (DIPLEGIA and QUADRIPLEGIA). Learning disability (with an IQ under 70) is present in around 75 per cent of all children but children with diplegia or athetoid symptoms may have normal or even high intelligence. Associated problems may include hearing or visual disability, behavioural problems and epilepsy.

The outlook for life is good, only the more severely affected cases dying in infancy. Although there is no cure, much can be done to help these disabled children, particularly if the condition is detected at an early stage. Assistance is available from NHS developmental and assessment clinics, supervised by community paediatricians and involving a team approach from experts in education, physiotherapy, occupational therapy and speech training. In this way many of these handicapped children reach adulthood able to lead near-normal lives. Much help in dealing with these children can be obtained from SCOPE (formerly the Spastics Society), and Advice Service Capability Scotland (ASCS).... cerebral palsy

A diagnosis (e.g. myocardial infarct) or a patient state that may be associated with more than one diagnosis (such as paraplegia) or that may be as yet undiagnosed (such as low back pain).... clinical condition

Paralysis of all 4 limbs and the trunk. (See also paraplegia.)... quadriplegia

Inability to retain faeces in the rectum until a movement appropriate to expel them. A common cause is faecal impaction, which often results from long-standing constipation. The rectum becomes overfull causing faecal fluid and small pieces of faeces to be passed involuntarily around the impacted mass of faeces. Temporary loss of continence may also occur in severe diarrhoea. Other causes include injury to the anal muscles (as may occur during childbirth), paraplegia, and dementia.

If the underlying cause of faecal impaction is constipation, recurrence may be prevented by a high-fibre diet. Suppositories containing glycerol or laxative drugs may be recommended. Faecal incontinence in people with dementia or a nerve disorder may be avoided by regular use of enemas or suppositories to empty the rectum.... incontinence, faecal

n. a benign tumour arising from the fibrous coverings of the brain and spinal cord (*meninges). It is usually slow-growing and produces symptoms by pressure on the underlying nervous tissue. In the brain the tumour may cause focal *epilepsy and gradually progressive neurological disability. In the spinal cord it may cause paraplegia and the *Brown-Séquard syndrome. Rarely, meningiomas may behave in a malignant fashion and can invade neighbouring tissues. Treatment of the majority of cases is by surgical removal if the tumour is accessible. The histological classification of malignancy is controversial, but some tumours may also require additional radiotherapy. Some patients have been known to have symptoms for as long as 30 years before the tumour has been discovered.... meningioma

1. suppression of sensation, usually in the lower part of the body, by the injection of a local anaesthetic into the *subarachnoid space. A very fine needle is used to reduce the amount of cerebrospinal fluid that escapes as the needle penetrates the dura. The technique has complications (headache, sepsis, paraplegia). The injection site for spinal anaesthetics is most often in the lumbar region of the vertebral column, the needle being inserted between the vertebrae (anywhere between the second and fifth). The extent of the area anaesthetized depends upon the amount and strength of local anaesthetic injected. Dilute local anaesthetic solutions are used when the sensory nerves are targeted rather than the motor nerves. Spinal anaesthesia is useful in patients whose condition makes them unsuitable for a general anaesthetic, perhaps because of chest infection; to reduce the requirements for general anaesthetic drugs; or in circumstances where a skilled anaesthetist is not readily available to administer a general anaesthetic. 2. loss of sensation in part of the body as a result of injury or disease to the spinal cord. The area of the body affected depends upon the site of the lesion: the lower it is in the cord the less the sensory disability.... spinal anaesthesia