Paraplegia is sensory or motor disorder in the lower extremities of the body. The impairment is due to damage caused as a result of congenital deformities or trauma and spinal injuries. The effects of paraplegia are predominantly seen in the thoracic, lumbar and sacral region. The damage caused as a result of paraplegia can lead to other issues such as monoplegia (dysfunction of one organ), paralysis and some times fecal incontinence and impotence.
Spastic paraplegia and flaccid paraplegia are two important forms of the disease which are differentiated based on the location. Flaccid paraplegia is associated with the lesion caused in the spinal cord; which in turn causes two significant forms of myelopathies compressive and non-compressive respectively. The compressive form of paraplegia occurs because of the destruction of the spinal cord due to pressure exerted on it. In most cases the pressures caused are because of underlying medical conditions such as neoplasms, degenerative spinal disease or hematoma. The compressive forms are predominantly located in extradural and subdural regions causing extra medullary and intramedullary complications such as neurofibroma and meningioma.
The lesions caused affect the spinal arteries causing ischemia eventually leading to tissue necrosis in the respective region. This leads to the development of edema in the spinal region causing compression and damage. Because of increased pressure, paraplegia can initiate complications such as pneumonia, pressure sores which are decubitus in origin. Often the pain associated with paraplegia radiates in the region of nerve damage. Vitamin B 12 deficiency also leads to the occurrence of paraplegia of non compressive origin.
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:
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.
Prevention of spinal cord injuries
Paralysis is a neurological disorder which is associated with the impairment of voluntary functions of the muscles. The important cause for paralysis is metabolic disorders of the neuromuscular functionalities. The attack of paralysis in the body is categorized into various types such as paraplegia (lower body), hemiplegic (one side of the body) and quadriplegia which is localized only to the legs. The motor and sensory activities are impaired at respective regions where the onset of paralysis takes place.
Causes of paralysis
The onset of paralysis has many predisposing factors and medical conditions. Thorough understanding and evaluation of these conditions paves the way for comprehensive diagnosis and treatment.
Trauma: Injuries to the head and spinal cord result in blood vessel and neural cell damage. In some cases paralysis associated with trauma can be localized and affects one region of the body. This phenomenon depends upon the site of the head injury and the peripheral neuromuscular fibre associations.
Infections and other causes: Paralytic occurrences can happen in patients who have a history of meningitis and abscesses present in the brain because of bacterial infections. Other causes of paralysis include Guillian Barre syndrome, cerebral palsy and multiple sclerosis.
Diagnosis and treatment
The definitive diagnosis of paralysis depends upon the source of its onset and progression. Paralysis neuromuscular dysfunction for which many causes are possible. Pathologically, paralytic sites indicate appearances of tissue necrosis caused because of gangrene associated hypoxia and ischemia. Cellular pathology often indicates dead cells and tissue debris because of necrosis. Surgical intervention is recommended in order to remove the necrotic tissue present in the regions like central nervous system.
Diagnostic interventions to paralysis include radiological examinations of the necrotic sites, nerve conduction studies in order to understand the myogenic and neurogenic abnormalities along with sensory and motor functions of a respective region. If malignancies are suspected, fine needle aspiration, cytology and biopsy tests are recommended to understand cellular pathology.
Treat of paralysis is mostly therapeutic in origin. It is necessary to identify the cause of the paralytic disease and to treat it appropriately with antimicrobial drugs in case of infections. Physiotherapy is advised to facilitate motor and sensory functions.
Bibliography / Reference
Collection of Pages - Last revised Date: January 20, 2019