Spastic paresis is a condition characterized by weakness in the legs. This is not an independent disease at all, but the symptomatology of the manifestations of a neurological ailment. The same term in medicine is used to indicate the complete cessation of the functioning of internal organs, for example, the bladder or intestines.
About the disease more
With spastic paresis, people experience a decrease in strength in the muscle group. The disease develops a second time, within the framework of any pathological condition or disease (for example, a violation of cerebral blood circulation, a tumor, and the like). This deviation is considered a special case of paralysis (muscle contraction problems). The very concept of “paresis” is often used in relation to muscles, the performance of which can be objectively assessed by a doctor. At the same time, the term “paralysis” is used to describe the state of muscles with immeasurable strength (for example, soft palate). Now consider the main causes that lead to the occurrence of the described disease.
The reasons for this unpleasant pathology
Spastic paresis can develop for many reasons. However, the following factors should be considered the most common:
- The presence of a tumor in the patient.
- Atrophy of the spinal cord or brain.
- The presence of lesions and disorders in the work of the spinal cord.
- Muscular spinal atrophy.
- The development of amyotrophic lateral sclerosis.
- Pathologies in the area of the ponytail.
- Motor and sensory polyneuropathy of a hereditary nature.
- The development of myopathy and polyneuropathy.
- The presence of a peroneal nerve lesion on both sides.
Other causes may be identified, however, before proceeding with treatment, you must definitely understand what exactly caused this condition. Therefore, it is necessary to act in this case not only with the help of medications, but also through physiotherapy, massages and therapeutic exercises. Next, let's talk about the symptoms of spastic paralysis and paresis.
Symptoms of this disease
At the moment, it is customary to distinguish two large categories of paresis. The first is a flaccid or peripheral form. The second is related to the spastic or central type. It is also worth highlighting a third, mixed group, in which patients may experience symptoms of both types of lesions.
It is worth saying that spastic paresis of the limbs always has its own symptoms, on the basis of which they make the diagnosis. The first thing you need to pay attention to is muscle tone. In this situation, it is always elevated, it is called hypertonicity. The second significant sign is the absence of malnutrition. That is, the affected muscles do not change in volume in any way and retain their original size throughout the disease. The third manifestation is hyperreflexia. In this case, an increased intensity of deep reflexes is revealed, which entails the emergence of clonus. But the surface reflex will be sharply reduced.
Pathological reflexes in this condition
There are also pathological reflexes, among them Oppenheim, Babinsky, Gordon and Schaeffer reflexes are often noted. They act as pathological manifestations of extension. There are also non-standard flexion reflexes, which include the reflexes of Zhukovsky, Rossolimo, Mendel and Ankylosing spondylitis.
Another clear sign of spastic paresis of the limbs are movements that involuntarily repeat on the side of the lesion. So, for example, if the patient bends a healthy leg in the knee, the affected limb will also bend in the same way, but with less force. It is also necessary to pay attention to the gait against the background of spastic paresis. In this condition, patients cannot raise a limb, so they drag it along the ground.
Paresis rating scale
To detect the presence of a patient with spastic lower paresis, and in addition, to assess its strength, you can use the developed special scale, in which muscle strength is determined from zero to five points:
- In the event that this is zero points, then arbitrary movements in the legs of a person are absent. This condition is called paralysis.
- If we are talking about one point, then there is a barely noticeable muscle contraction, but there are no movements in the joints.
- With two points, the range of motion is minimal in the joints, they are possible only in the horizontal plane and without any overcoming of gravity.
- If we are talking about three points, the movements are not limited as much as in the previous versions, and the muscles can overcome the force of friction and gravity. That is, patients are able to tear off their legs from the floor.
- If it is four points, then the force is minimally reduced, and the movements in the joints are fully preserved.
- Five points are set for healthy people under the condition of normal muscle strength and in the presence of a full range of movements.
Diagnosis of the disease
Spastic paresis of the lower extremities is not so difficult to identify in patients. This happens, as a rule, without involving any additional diagnostic measures. Sometimes this manifestation may be missed when examining the patient. In this situation, it is detected by using the Barre test. This technique involves keeping the limbs in weight when determining muscle strength. Moreover, this test can be carried out without determining the strength. The fact is that in twenty seconds of the study, the limb, even with the presence of minimal paresis, will begin to decline quickly, unlike a healthy one. Among other things, the doctor, as part of the diagnosis, is going to analyze complaints and an anamnesis of pathology:
- It is necessary to find out how long ago a decrease in strength appeared in a particular muscle group (in the arms, legs, neck).
- What exactly preceded the complaint (consumption of canned foods, the presence of diarrhea (diarrhea), severe headache, fever, and so on).
- Did anyone in the family have such complaints.
- Whether the patient’s profession or area of residence is associated with the action of harmful substances (salts of heavy metals, organic solvents, etc.).
Now we find out how the therapy of the pathology under consideration is carried out.
Treatment of this pathology
Spastic paresis of the lower extremities is treated only in a complex manner. In treatment, thermal procedures should be used along with massages. This greatly helps to stabilize the conduct of an active impulse to the muscles, improving their trophism. When the patient can actively move the limb, massage should be combined with exercise therapy and with the use of the load, which should be increased gradually. Moreover, any exercises should be metered for the patient, and massages should be performed only by a professional. In addition, treatment includes such events:
- The use of medical drugs.
- The use of orthoses.
- Conducting medical blockades.
- The implementation of surgical intervention.
The choice of treatment methods is always strictly individual, it depends on the location and nature of spastic paralysis.
Central spastic paresis
This is a paresis that occurs in the case of damage to the motor cortical centers or the main motor path at the level of the spinal cord and brain. With the central form of paresis, muscle strength decreases to varying degrees in patients. In some cases, patients are concerned about awkwardness and fatigue, while in others there is an almost complete loss of movement.
Since, with central paresis, a part of the spinal cord below the lesion area remains intact, it tries to compensate for motor impairment. This leads to an increase in muscle tone, and in addition to an increase in normal reflexes and the occurrence of pathologies that a healthy person does not have. Due to pathology, contractures can form, which are a restriction of movements in the joints.
Spastic paresis in a child
It is worth saying that this ailment in children is not at all an independent disease. Such a paresis in a child is congenital or acquired. The congenital form occurs against the background of a birth injury, due to a complicated pregnancy and adverse factors suffered by a woman during the bearing of a baby, as well as under the influence of viral diseases and other negative manifestations. Sometimes congenital paresis in children can mildly manifest after some time. The acquired type of pathology in young patients occurs for various reasons:
- Due to circulatory disorders.
- Against the background of the appearance of a tumor in the child's body.
- As a result of migraine, stroke, multiple sclerosis, the development of this form of the disease is provoked.
- Injury, especially on the background of damage to the head or back.
- Viral pathologies, as well as the negative impact of chronic diseases.
Reviews of doctors about this pathology
So, spastic paresis is a sign of damage to the nervous system. This is, first of all, a decrease in muscle strength due to damage to the nerve fibers that connect the brain to the muscles. Doctors in the reviews write that this is a fairly serious disease, which must be thoroughly prevented and avoided. For this, doctors insist on the timely treatment of infectious diseases, as well as on giving up bad habits.
Of course, doctors report that it is very important to lead a healthy lifestyle, paying attention to regular walks of at least two hours a day, physical education, observance of night sleep for at least eight hours and so on.
Doctors also report that as part of the prophylaxis of spastic paresis of the legs, it is necessary to follow a diet, include foods rich in vitamins in the diet. It is noted that in the event of the first signs of this pathology, timely contact with a doctor is required. Do not delay with this.