Spinal Cord Injury

Myelopathy or spinal cord injury is a problem in the spinal cord that causes numbness and loss of motor (muscular) control. Spinal cord injuries can be caused due to trauma such as accident and falls and Disease caused due to spina bifida, polio, tumors etc. The effect of spinal cord injuries be Complete (total function and sensation is lost below the injured point) or Incomplete (Sensation is not lost and only few functions of the part suffers malfunctioning).

Spinal cord injuries in general occur due to the following:

• Road accident, either car or motorcycle
  
• Injuries caused due to sports
  
• Gunshot wounds
  
• Stabbing with knife
  
• Fall from an elevated structure
  
• Accidents while diving

Symptoms of spinal cord injury include weakness, numbness and reduced synchronization from beneath the point of the injury. There is loss of feelings and tingling sensation. There may be excessive pain or loss of bladder or bowel control. Quadriplegia is an injury at the neck level of the spine and induces difficulty in breathing and paralyzes the arms, legs and trunk. Paraplegia is an injury to the lower spine and results in weakness and loss of mobility and feeling in the legs and the lower part of the body.

• Corticosteroid drugs are prescribed to ease the injury and perk up chances of healing.
  
• Surgery is required for severe cases of damage.
  
• Complete bed rest is required during the recovery period.
  
• Traction might be suggested depending on the case.
  
• Additional treatment for bladder control, urinary infections and bed sore is required.
  
• Muscles have to be strengthened through physiotherapy.

Prevention of spinal cord injuries

• Driving or riding at safe speed limits and following rules thus avoiding traumatic road accidents.
  
• Do not resort in violence, assault and physical fights that can lead to gun shots or knife wounds.
  
• Keep floor dry so as to prevent falls and when working from a height take all precautionary measures to safe guard your spine.
  
• In sports, use the right equipments and gears, and do not over do any activity.
  

Sciatica

Sciatica is described as pain, numbness or tingling in the leg due to compression of the sciatic nerve. The sciatic nerve runs down the back of each leg from the lower spine. The pain associated with sciatica can range from dull ache to excruciating pain that makes movement difficult. The pain may be felt in the buttock, down the back of the leg, below the knee and in the foot.

Causes of sciatica

• Disc herniation
  
• Pelvic fracture
  
• Spinal tumors
  
• Pelvic injury
  
• Pain along one side of the body
  
• Worsening in cold weather
  
• Osteoarthritis causing pressure on the sciatic nerve
  

A physical examination along with checking of reflexes on bending, lifting the leg etc are done. X-ray and MRI might be done. Typically sciatica is indicative of another medical problem; which must be attended to. NSAIDs and ice packs provide relief from the pain. Lifting of heavy objects and strenuous back bending are to be avoided. Physical therapy, massage therapy and stretching exercises might help in tackling chronic sciatica.

Paraesthesias

Paraesthesias, also spelled paresthesias, is a medical term that refers to abnormal sensations in the body, typically involving a feeling of tingling, pricking, numbness, or "pins and needles." These sensations are often described as uncomfortable or abnormal and may be experienced in various parts of the body, such as the hands, feet, arms, legs, or other areas.

Paraesthesias can be caused by a variety of underlying medical conditions or factors, including:

• Nerve Compression or Irritation: Pressure on or damage to nerves, such as in conditions like carpal tunnel syndrome or sciatica, can lead to paraesthesias.
  
• Nerve Disorders: Diseases that affect the nervous system, like peripheral neuropathy, multiple sclerosis, or diabetic neuropathy, can result in abnormal sensations.
  
• Poor Circulation: Reduced blood flow to specific body parts can lead to paraesthesias, as tissues may not receive sufficient oxygen and nutrients.
  
• Vitamin Deficiencies: Deficiencies in certain vitamins, particularly B vitamins like B12 and folate, can contribute to nerve-related symptoms, including paraesthesias.
  
• Infections and Inflammatory Conditions: Conditions like shingles, Lyme disease, or autoimmune diseases can cause nerve inflammation and lead to abnormal sensations.
  
• Medications and Toxins: Some medications or exposure to toxins can induce paraesthesias as a side effect.
  
• Trauma or Injury: Physical injury or trauma to nerves or tissues can result in temporary or chronic paraesthesias.
  
• Psychological Factors: In some cases, paraesthesias may be related to psychological stress or anxiety.
  

Some medications have the potential to affect the nervous system and cause these symptoms. It's important to note that individual responses to medications can vary, and not everyone will experience paraesthesias as a side effect. Here are some categories of medications and specific drugs that are known to be associated with paraesthesias:

• Chemotherapy Drugs: Several chemotherapy agents, such as paclitaxel, vincristine, and cisplatin, can cause peripheral neuropathy, leading to paraesthesias in the hands and feet.
  
• Anticonvulsant Medications: Some anticonvulsants, including phenytoin and carbamazepine, may cause paraesthesias as a side effect.
  
• Antidepressant Medications: Tricyclic antidepressants like amitriptyline and selective serotonin reuptake inhibitors (SSRIs) like fluoxetine have been associated with paraesthesias in some individuals.
  
• Antiretroviral Drugs: Certain medications used to treat HIV, such as zidovudine and didanosine, may lead to peripheral neuropathy and paraesthesias.
  
• Antibiotics: Some antibiotics, particularly fluoroquinolones (e.g., ciprofloxacin), have been linked to peripheral neuropathy and paraesthesias.
  
• Antifungal Medications: Antifungal agents, such as fluconazole, can occasionally cause peripheral neuropathy and associated symptoms.
  
• Antihypertensive Medications: Diuretics and calcium channel blockers are classes of drugs that may rarely induce paraesthesias.
  
• Statins: Statin medications used to lower cholesterol levels, like atorvastatin and simvastatin, have been reported to cause muscle-related paraesthesias in a minority of users.
  
• Immunomodulatory Drugs: Medications used for autoimmune diseases, like interferons and monoclonal antibodies, can result in paraesthesias.
  
• Local Anesthetics: Certain local anesthetics used in medical or dental procedures may lead to temporary paraesthesias.
  

Vitamin B3, also known as Niacin, is an essential nutrient that plays a crucial role in various bodily functions, including energy metabolism and maintaining the health of the nervous system. While niacin deficiency can lead to neurological symptoms, including paraesthesias (abnormal sensations like tingling or numbness), it is rare in well-nourished individuals.

However, high doses of niacin, often used in the treatment of certain medical conditions like high cholesterol, can indeed cause paraesthesias as a side effect. This is a well-known side effect of niacin therapy and is commonly referred to as the "niacin flush." The niacin flush involves a warm, tingling sensation, often accompanied by redness and flushing of the skin, particularly on the face and upper body. Some people may describe it as a temporary, uncomfortable form of paraesthesias.

The niacin flush is usually harmless and transient, lasting for about 15-30 minutes after taking a high-dose niacin supplement. Over time, the body may develop some tolerance to this side effect. Nevertheless, individuals who experience severe or persistent paraesthesias or other adverse effects from niacin should consult their healthcare provider. It's important to take niacin supplements as directed by a healthcare professional, as high doses can have potential side effects, including liver toxicity, gastrointestinal disturbances, and other adverse reactions.

Diagnosis and management of paraesthesias typically involve a thorough medical history, physical examination, and, if necessary, further diagnostic tests such as nerve conduction studies, electromyography, blood tests, or imaging studies. The underlying cause of paraesthesias must be identified and treated accordingly. Management may involve addressing the primary medical condition, physical therapy, medication, or lifestyle changes to alleviate the abnormal sensations and improve the patient's overall well-being.