PARALYSIS

General Information

DEFINITION--The loss of ability to move a part of the body caused by the inability to contract one or more muscles. The condition varies in degree and severity from paralysis of one small muscle to paralysis of almost the total body. The paralysis may be temporary or permanent. Types include: paraplegia (partial or complete paralysis of both legs), quadriplegia (partial or complete paralysis of both arms and legs), and hemiplegia (partial or complete paralysis of one side of the body).

BODY PARTS INVOLVED--Brain; spinal cord; nervous system; muscles.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS--

The following vary, depending on the site and extent of damage:

• Loss of movement and sensation in affected arms or legs.
• Loss of urinary and bowel control; impaired sexual function; loss of normal blood pressure; loss of body-temperature control; constipation.
• Difficulty speaking, understanding or recognizing words.
• Blurred, double or decreased vision.

CAUSES--

Normally, the brain originates the impulses for muscle movement. These impulses travel via the spinal cord and peripheral nerves to the muscles. Paralysis occurs when there is an injury or disruption in this nerve pathway. Causes include:

• Stroke (most common). Stroke may be caused by bleeding in brain, or blood clot or obstruction of blood vessel to brain.
• Brain: tumor, abscess, hemorrhage, infection (encephalitis).
• Spinal cord: injury (from an accident); pressure on the spinal cord (disk prolapse, cervical osteoarthritis), decompression sickness.
• Disease: multiple sclerosis, poliomyelitis, myelitis, Friedreich's ataxia, meningitis, motor neuron disease.
• Nerve disorders (neuropathies): secondary to disorders such as diabetes mellitus, vitamin deficiency, liver disease, alcoholism, cancer and toxic effects of drugs or metals.
• Muscle disorders such as muscular dystrophy and sometimes, myasthenia gravis.

RISK INCREASES WITH

• Any activity with a high risk of injury.
• Excess alcohol consumption or drug use.

HOW TO PREVENT

• Observe safety precautions; don't take risks.
• Don't dive into shallow water.
• Wear protective headgear during contact sports and while riding a bicycle or motorcycle.
• Obtain medical treatment to control any chronic medical condition.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory studies of blood, urine and cerebrospinal fluid, x-rays of the injured area.

APPROPRIATE HEALTH CARE

• Treatment of any underlying cause.
• Hospitalization; intensive care if paralysis affects the breathing muscles.
• Surgery to limit further spinal-cord damage or to remove bones or a tumor.
• Time in an extended-care facility or special rehabilitation facility (sometimes).
• Physical and occupational rehabilitation.
• Psychotherapy or counseling for depression or for sexual problems.

POSSIBLE COMPLICATIONS--Kidney infections, especially if a urinary catheter is needed; lung infections; constipation; fecal impaction; pressure sores; deep-vein blood clot; depression; limb deformities.

PROBABLE OUTCOME--Depends on the extent of injury. Damaged spinal cord and nerves are limited in their ability to recover.

How To Treat

GENERAL MEASURES----The more you can learn and understand about your disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.

MEDICATION--Your doctor may prescribe:

• Antibiotics to fight infection.
• Medications to control hypertension, diabetes or other underlying disorders.
• Anticoagulants to prevent blood clot.
• Stool softeners and laxatives.

ACTIVITY--Resume activities gradually to the extent possible. With rehabilitation, many lost functions can be compensated for or restored. Use passive exercise for paralyzed or partially paralyzed muscles to prevent contractures.

DIET--

• Eat a high-fiber diet to prevent constipation.
• If you have a urinary catheter, drink up to 16 glasses of water a day to prevent bladder stones and urinary-tract infections.

Call Your Doctor If

Signs of infection occur during treatment.