Paraplegia is paralysis caused by pathology, trauma. With it, the upper and lower limbs are affected. Proceeding from this, upper paraplegia, lower, is distinguished.
general information
The disease affects both lower (upper) limbs simultaneously. It is usually provoked by disorders of the spinal cord. The most common cause, according to statistics, is car accidents. Much less often, but still there is paraplegia of the lower extremities, upper, provoked by diseases of the spinal cord, spine.
There are two types of subdivisions:
- paraplegia caused by a lower back injury;
- tetraplegia, provoked by injuries of the upper spine.
With the last, four limbs are paralyzed. Upper isolated also exists, but is extremely rare. Tumors, pinpoint hemorrhages can lead to it.
Paraplegia is a pathology, most of which are affected by the use of wheelchairs. Defects visible to the eye are not the only ones accompanying the disease. Acquired and hereditary spastic paraplegia are associated with a large number of violations of the internal systems of the body.
Causes
The disease provokes damage:
- spinal cord;
- ponytail;
- nerve roots.
The risk group is men aged 15-45 years, that is, people who are most likely to get into traffic accidents. In addition, there are hereditary paraplegia provoked by genetic factors.
Symptomatology
Paraplegia is a disease accompanied by the following symptoms:
- movement disorders;
- pain syndrome;
- trouble breathing
- impaired functioning of the reproductive, urinary systems;
- sphincter dysfunction;
- vegetative, sensory disturbances.
Traffic problems
Paraplegia is a violation in which movements become almost or completely impossible. How much paralysis affects the body depends on the extent of the injury. In some cases, uniform paraplegia is diagnosed when the spread occurs symmetrically with respect to the spine. Irregular violations are also possible. It depends on which part of the spinal cord was hit.
In trauma, nerve connections collapse, as a result of which movements can sometimes be observed spontaneous and even violent. Muscle tone becomes elevated, to which the flexors are most susceptible. If a person tries to straighten a limb, this leads to a worsening of the situation. Upper, lower paraplegia is characterized by spasticity. If nerve roots are affected, muscle hypotension is highly likely. In this case, flaccid paraplegia is diagnosed.
Sensory dysfunction
When injured , skin sensitivity is impaired. At the same time suffer:
- ability to perceive pain;
- feeling of touch;
- sensation of temperature.
Sensitivity is generally impaired. Those sensations that are unusual for healthy people, which provokes upper, lower paraplegia, are usually called paresthesias in science. If this reflects a loss of sensation, a person can easily get injured or get burned and not even notice that this happened. If sensitivity is completely lost, there is a high probability of pressure sores, since the violation is accompanied by trophic disorders.
The sensitivity of the body allows a healthy person to understand what position in space he occupies, what pressure they exert on him, how great the shear force is. In disorders caused by paraplegia, this feeling is disturbed, so people with lesions of the lower extremities can understand what position they occupy only if they look at them. To use your hands, you need to look at them. At the same time, balancing difficulties arise, since the abdominal press is also affected by paralysis. Patients diagnosed with paraplegia complain of dizziness, are afraid of heights.
Pain syndrome with paraplegia
Both acquired and spastic paraplegia of Strumpel is characterized by persistent pain syndrome. When injured, he appears immediately, but remains for life. Pain can occur in parts of the body where sensitivity is not impaired, but areas that have lost sensitivity are also affected.
Damage to the spinal cord means that the nerve fibers are not functioning properly, and the brain receives distorted information that is not true. Some data channels are blocked completely.
Pain syndrome with pathology greatly affects people, causes depression, reduces the quality of life, provokes regular stress, anxiety. In some, the syndrome appears, then disappears, then returns again, in others it is permanent. Often it is precisely through pain that it is possible to make a final diagnosis - for example, to identify problems of the skin, intestines, and bladder. In some cases, pain is provoked by fatigue, stress, and even feelings. Numerous cases are known to medicine, when a change in temperature in a room influenced the strength of pain.
Vegetative dysfunction
Spastic paraplegia is manifested in:
- hyperreflexia;
- dysflexia;
- pressure surges;
- headaches;
- hyperhidrosis;
- chills;
- goosebumps.
Main reasons:
- infections
- bladder deformity;
- skin problems;
- hemorrhoids;
- catheterization.
Perhaps a violation of the temperature balance of the body, provoked by the incorrect functioning of the coronary vessels. Sweating is characteristic of areas below the injured area.
Treatment
What can be counted on if paraplegia has been diagnosed? Unfortunately, treatment today does not exist as such. Once the injury has been received, efforts must be made to eliminate the acute consequences. As a rule, the patient is operated on, fractures are eliminated, the general condition of the body is assessed, the spinal cord is examined, the extent of the lesions and their nature are revealed.
Next, the rehabilitation phase begins. At this time, doctors help the patient restore the functions of the body as much as possible. Regarding the muscles located below the injured area, the control of residual functions is introduced. For areas of the body above the lesion, the residual force potential is evaluated. This helps to choose the best exercises, procedures aimed at training a person to serve themselves. Of course, even the most effective rehabilitation shows results only in the distant future.
Additional stages of treatment
If the patient first became ill with a respiratory disease after receiving an injury, artificial lung ventilation would have to be arranged. After some time, create postural drainage, teach a person to cough. Apply specialized techniques developed for patients with paraplegia. In the future you will have to do this regularly.
Another effective technology is kinesitherapy. This technique is designed so that the patient's joints can again move. It involves working with the affected area. The main task of the doctor is to prevent muscle contractions leading to limited mobility. In addition, they are working on strengthening muscles.
The treatment is rather routine, based on the patient's capabilities and over time involves a set of a wider range of tasks. Start:
- learning how to get out of bed;
- adoption of a pose in a wheelchair;
- maintaining balance in a sitting position;
- sitting independently;
- stroller control.
With paraplegia give disability. These people require regular care and help, and the duration of life depends on this. If medical procedures, medical procedures are followed carefully, then a person will be able to live long enough. But the very first hygienic difficulties lead to numerous complications, infection and inflammation of internal systems and organs, to trophic problems, which can provoke sepsis. As soon as the infection becomes generalized, the risk of death is increased.
Familial disease
Strumpel paraplegia is a disease that relates to:
With it, the pyramidal spinal paths are affected from two sides. This disease is caused by genetic prerequisites: inherited. In most cases, the inheritance of a spastic subspecies occurs according to a recessive type, but there is a likelihood of a dominant one. The disease is severe. But pure paraplegia is usually transmitted by the dominant gene. Assume that there are some pathological genes that provoke family pathology. It has been suggested that it is from these genes that it follows at what age the disease begins to develop.
With Strumpel paraplegia, the pyramidal lateral paths degenerate over time. At the same time, changes occur in Gaulle beams. The cerebral cortex suffers. The disease is heterogeneous. Shrumpel in his works described a spastic familial subtype of the disease, which is rarely recorded in practice. Spastic paraparesis is much more common, in which the affected area is the lower extremities. In these cases, spasticity prevails over paresis. Today's science finds the cause of the disease in the sixth field of the cerebral cortex, where the extrapyramidal fibers begin.
Disease development
Family paraplegia usually begins completely unnoticed. At first, a person notes that his legs quickly and strongly get tired, eventually he feels that the limbs are moving as if tight. Muscle tone increases, which is reflected in the reflex movements of the tendons. Often observe the Babinsky reflex.
The progression of the disease shows clones of the feet, knees. Next, other disorders of limb flexion are diagnosed. The tone grows very strongly, the muscles weaken, but there is still no paralysis as such. A person’s gait changes, it becomes “spastic”. The joints are deformed, their contours change, and protective reflexes are provoked.
In most cases, patients retain skin reflexes, the pelvic organs can function. The level of intelligence does not change, a person can coordinate their movements and does not record violations of sensitivity. But after some time, the upper limbs are involved in the negative process. This does not happen in 100% of cases, but there is a probability of such a development. Muscle tone grows in the hands, tendons shrink reflexively, pseudobulbar symptoms are not uncommon.
Misfortune never comes alone
Extremely rare are cases where spastic paraplegia appears on its own, without being accompanied by other disorders. Other internal systems usually suffer. Very often, with paraplegia caused by genetic prerequisites, inherited ataxia is also diagnosed. There is a connection between paraplegia and amyotrophic syndromes. But to this day, doctors do not know whether diseases are phenotypic with respect to one process or are each provoked by their own genome.
Often, paraplegia is accompanied by atrophy of the nerves responsible for vision, weakness of the external eye muscles, nystagmus and dysarthria. With pathology, mental changes, epilepsy, hyperkinesis, intentional trembling are recorded.
Pathology and age
There is no exact information regarding at what age spastic paraplegia affects a person who has a hereditary predisposition to it. Studies were conducted among patients taking into account family affiliation, which allowed doctors to establish accurately: even if we are talking about relatives, the disease still manifests itself at different ages, there is no similarity. In some, the first manifestations are noticed immediately after birth, in others, pathology is found in middle, older age.
If we are talking about pure paraplegia, then we can talk about certain statistics: risk group - age 10-20 years. The disease is very slow, but still its progress is felt. Often, patients live quite a long time, even live to old age. There are known cases of increasing symptoms and provoking infections.
Flaccid paraplegia
The violation is associated with the defeat of the neurons responsible for movement. The reason may be:
- injuries
- polio;
- tumor;
- polyneuritis;
- plexitis.
Sluggish paraplegia is characterized by a slow, gradual, steady attenuation of reflexes. Tendons suffer primarily, but over time, the process expands. Muscles decrease in size, electrical excitability decreases. The most accurate method for detecting a disease is an electromyogram.
With flaccid paraplegia, atony is possible. In most cases, this development indicates a rupture of the spinal cord almost completely (or completely). The pelvic organs lose their working capacity, it is impossible to move the body below the affected area. But there is another option. If the pathology is sudden, had no prerequisites, perhaps the reason is diaschis, when neurons temporarily cease to function.