Paralysis is a complete absence of motor movements, which is caused by a lesion nervous system. Typically, paralysis is not an independent disease, but develops secondary to various diseases. The Yusupov Hospital employs professors and doctors of the highest category. They are leading experts in the treatment of paralysis. The cause of motor dysfunction is determined through a comprehensive examination of the patient, which includes:
- modern neuroimaging methods (computer and magnetic resonance imaging);
- electroencephalography;
- angiography of cerebral vessels;
- multislice computed tomography.
To treat patients, modern drugs registered in the Russian Federation are used, which have high efficiency and a minimal range of side effects. The rehabilitation clinic offers patients comprehensive programs for restoring impaired functions. They allow the patient to save money and receive a full range of procedures at a stable price.
The Yusupov Hospital is equipped with modern mechanical and computerized simulators from leading companies in the world. Rehabilitators are fluent in innovative methods of physical therapy, perform all types of massage, and use non-traditional methods of treatment, which include reflexology. Occupational therapists, speech therapists, neuropsychologists, and neurodefectologists help the patient adapt to life in new conditions and teach self-care methods.
Causes of paralysis
Paralysis can develop due to the following pathological conditions:
- acute violation of cerebral or spinal circulation;
- neoplasms of the brain or spinal cord;
- abscesses of the brain or spinal cord;
- traumatic brain and spinal injuries;
- diseases accompanied by myelin breakdown (multiple sclerosis, multiple encephalomyelitis;
- inflammatory diseases of the brain or spinal cord.
Paralysis develops from poisoning with heavy metal salts, nerve agent poisons, alcohol, industrial poisons and other toxic substances. The cause of paralysis can be immunoinflammatory diseases, botulism, myasthenia gravis. Paralysis may develop if the brain is damaged. Complete immobilization occurs with botulism, myopathy, and epilepsy. Paralysis is detected in patients suffering from motor neuron diseases (amyotrophic lateral sclerosis, spinal muscular atrophy).
Types of paralysis
Depending on the number of limbs affected, paralysis may be called:
- monoplegia - when one limb is affected on one side;
- paraplegia – if the disease manifests itself as paralysis of two limbs of the same name (arms or legs);
- triplegia – when three limbs are affected;
- tetraplegia – if all 4 limbs are paralyzed.
Incomplete paralysis is called paresis. Depending on the level of damage to the central motor neurons, there are 2 types of motor dysfunction: central paralysis (develops as a result of disorders of the corticospinal tract) and peripheral, flaccid paralysis, which develops as a result of damage to the peripheral motor neuron.
Symptoms of paralysis
The main symptom of paralysis is a lack of muscle strength in the affected muscle or muscle group. Depending on the damage to a particular muscle, the patient may experience:
- gait disturbance;
- foot drop;
- drooping head;
- lack of muscle strength in the limbs.
Cranial nerve palsies are manifested by impaired movement of the eyeballs, nasal sound, slurred speech, sluggishness of the tongue and other symptoms associated with weakness or complete dysfunction of the facial muscles.
The symptoms of central paralysis are directly dependent on the level of damage. With the development of pathological processes in the central gyrus of the cerebral cortex, the function of the upper and lower limbs on the opposite side of the pathological focus is lost. Damage to the pyramidal fibers of the brain stem of the head causes hemiplegia on the opposite side, which is combined with central paralysis of the muscles of the face and half of the tongue. With bilateral damage to the central motor neuron of the cranial nerves, pseudobulbar palsy develops.
Signs of central paralysis are:
- an increase in tendon reflex perceptions, accompanied by an expansion of the reflexogenic zone;
- maintaining muscle tone;
- the occurrence of pathological reflexes and synkinesis (involuntary movements of a limb or other part of the body, accompanying another voluntary or passive movement).
Muscle tone increases due to an increase in reflex muscle tone and their uneven distribution. The muscles are in constant tension. When performing passive movements, their resistance is overcome with the application of significant effort.
Peripheral paralysis results from damage to the second motor neuron. There is a weakening or complete absence of reflexes in the tendons, muscle tone decreases, muscles atrophy, and the nerve fiber degenerates. Due to the fact that nerve fibers die, an imbalance occurs in the muscles and cells of the anterior horns, from where neurotrophic impulses come, which are responsible for stimulating metabolic processes. The clinical picture of peripheral paralysis depends on the degree and level of damage to the peripheral neuron. When the anterior horns and nuclei of the cranial nerves are involved in the pathological process, peripheral paralysis is combined with characteristic fascicular twitching and muscle atrophy.
All movement disorders that are caused by pathology of the nuclei, brain stem, and cranial nerves are bulbar palsy. If the peripheral nerve is subject to deformation, paralysis of the innervated muscle occurs. In patients, sensitivity is impaired, since the peripheral nerve contains sensory fibers. Damage to the cervical, brachial, dorsal and sacral plexuses is a combination of peripheral paralysis of the muscles innervated by the plexus and lack of sensation.
Examination of patients with paralysis
When interviewing a patient with paralysis, the neurologist clarifies:
- how long ago the lack of strength in any muscle group occurred;
- what immediately preceded the appearance of complaints (diarrhea, consumption of canned foods, severe headache, fever);
- whether anyone in the family had similar signs of the disease;
- whether the patient's place of residence or occupation is associated with exposure harmful substances(salts of heavy metals, organic solvents).
Then the doctor conducts a neurological examination: assessing muscle strength on a five-point scale, looking for other symptoms of neurological pathology (facial asymmetry, lack of reflexes, muscle thinning (atrophy), strabismus, swallowing disorders). After a physical examination, he prescribes tests. A general blood test can detect signs of inflammation (increased erythrocyte sedimentation rate, leukocyte count), increased levels of muscle metabolic products (creatine kinase). A toxic blood test may reveal signs of inflammation.
A test with proserin allows you to identify myasthenia gravis (a disease characterized by pathological muscle fatigue). Electroneuromyography at the Yusupov Hospital is performed by neurophysiologists - leading experts in the field of physiology of the nervous system. Using a computer program, they assess the speed of nerve impulse transmission along nerve fibers and determine conduction blocks. Electroencephalography allows us to evaluate the electrical activity of different parts of the brain, which changes in various diseases. Computed tomography and magnetic resonance imaging of the head and spinal cord make it possible to study their structure layer by layer, to identify a violation of the structure of its tissue, to determine the presence of hemorrhages, abscesses (cavities filled with pus), neoplasms, and foci of decay of nervous tissue. Using magnetic resonance angiography, the patency and integrity of arteries in the cranial cavity are assessed and brain tumors are detected. If indicated, patients are consulted by a neurosurgeon.
Treatment of central paralysis
The choice of treatment methods for patients with paralysis depends on the cause and type of disease, the degree and level of damage to the nerve fiber. In the presence of central paralysis, patients are treated for the underlying disease with treatment of the paralysis itself at the same time. If the vessels are affected, the immobilized limb is placed in a position that does not interfere with the normal blood supply.
Drug therapy is aimed at intensifying metabolism in the nerves, blood circulation in small vessels, and improving nerve and synaptic conduction. Conservative therapy brings results when the morphological substrate has survived, allowing the restoration of muscle function. Neurologists at the Yusupov Hospital select a cure for paralysis individually. In severe cases, the tactics for managing patients with paralysis are discussed at a meeting of the expert council. Doctors collectively decide on the choice of treatment method.
Physiotherapeutic treatment, balneotherapy, physical therapy and reflexology are widely used. Electrophoresis of medications helps restore blood circulation to the affected area of the brain. For inflammatory diseases, UHF and microwave treatment is used. Electrical stimulation in the area of the immobilized limb is carried out at the motor points of the antagonist muscles. This helps relieve increased tone and reduce the reflex response of paralyzed muscles.
Electrical stimulation is combined with taking muscle relaxants and acupuncture. To reduce the risk of contractures, therapy is carried out with warm ozokerite or paraffin. Positive dynamics are sometimes observed when using cold.
Physical rehabilitation for central paralysis begins with massage, and after a week or a week and a half, physical therapy begins. For drug therapy of paralysis, benzodiazepines, baclofen, and dantrolene are used. Anticholinesterase drugs are also used to treat central paralysis.
Complex therapy of peripheral paralysis
When treating peripheral paralysis, neurologists at the Yusupov Hospital direct all efforts to eliminating the cause that caused the impairment of motor function. IN difficult cases Neurosurgeons at partner clinics perform surgery. The treatment regimen for peripheral paralysis is developed in such a way as to eliminate the signs and consequences of the disease. The rehabilitation clinic uses innovative methods of physical therapy, physiotherapeutic treatment and various types of massages, acupuncture. To restore motor activity, the patient is prescribed dosed walking, during which the patient learns to step on the paralyzed limb.
Drug treatment is carried out under the supervision of a neurologist. Doctors use the following medications for paralysis:
- proserin is a synthetic agent that leads to the accumulation of acetylcholine in the synaptic space;
- dibazol - available in the form of solutions for injection, tablets and suspensions;
- melliktin - supplied to the pharmacy chain in the form of powder and tablets;
- solution of thiamine chloride - vitamin B1, which restores nerve fibers.
Physiotherapeutic therapy for peripheral paralysis is long-term, but quite effective method treatment. Physiotherapeutic procedures will help restore partial motor functions, so they are prescribed in combination with other treatment methods. In order to identify the cause and undergo effective treatment for paralysis using innovative methods, call the Yusupov Hospital.
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Paralysis as a result of damage to the brain and spinal cord is clinically manifested by increased muscle tone and spasm, while the limbs bend at the joints and it is impossible to straighten them without external effort. With a prolonged bent position, muscle contractures are formed, that is, chronic spasm is further strengthened by scar changes in the muscles, and the limb is no longer able to straighten even with the application of force. Half of the body becomes cold and cyanotic, the tissues are swollen, the skin becomes thinner. Half of the face becomes mask-like with sagging of the eyelids and corner of the mouth, and the sensitivity of half of the tongue may change.
- Localization of the lesion
If the right hemisphere is damaged, the left half of the body is paralyzed; if the left hemisphere is pathological, the right half is paralyzed. Right-sided paralysis may occur with severe speech impairment. This type of hemiplegia is the most common, since it is atherosclerotic changes in the left middle cerebral artery that cause the majority of ischemic strokes.
Left-sided hemiparesis is observed less frequently; it is more likely to be associated with motor disorders and mental manifestations, since the centers responsible for the psyche are located in the right hemisphere.
Treatment methods
The result of treatment for paralysis depends on the disease that caused it, and the sooner the correct diagnosis is made, the sooner treatment can begin.
The Medicine 24/7 clinic has high-precision diagnostic equipment, but the main resource is specialists who correctly interpret the identified changes and develop the optimal therapeutic approach.
- Therapeutic tactics for strokes
Today, the tactics of early active surgical treatment of hemorrhagic strokes are used, which reduces the likelihood of developing persistent paralysis of half the body. In case of ischemic stroke, already at the “ambulance” stage, the dissolution of blood clots blocking a cerebral vessel is carried out. All these measures are aimed precisely at reducing the likelihood of developing paralysis.
- Additional therapies
When paralysis has occurred, a special role is given to physiotherapy and physical therapy, which develop spastically bent limbs and prevent the formation of contractures. During rehabilitation, it is impossible to do without professional therapeutic massage and manual therapy.
At Medicine 24/7, special devices help create effective loads for developing joints, including using low-intensity laser radiation. The staff of the Medicine 24/7 clinic knows all methods of restorative manipulations; in addition, individual rehabilitation programs for neurological patients are developed, focused on the characteristics of the patient himself and his illness.
Paralysis is the loss of the ability to move at will. Most common reasons paralysis are stroke and injuries to the head, neck and spine.
Causes
Paralysis can also occur due to:
- degenerative diseases of nerves and muscles (multiple sclerosis, myasthenia gravis, poliomyelitis, Parkinson's disease, Lou-Gehrig's disease);
- tumors of the brain or spinal cord; infections of the nervous system (botulism, encephalitis).
Temporary paralysis can occur with Guillen-Barr syndrome, migraines, and seizures.
Types of paralysis
Doctors classify paralysis by location and severity:
- paraplegia - paralysis of the legs;
- quadriplegia - paralysis of the arms, legs and torso at the site of injury or abnormality of the spine;
- hemiplegia - paralysis of one side of the body.
A paralyzed person cannot move at will or control the affected part of the body. Depending on the cause and type, the paralysis may be widespread or limited to one limb; temporary or permanent.
Some paralyzed people have uncontrollable muscle spasms (spastic paralysis) or completely relaxed muscles (flaccid paralysis).
Symptoms
With paralysis, other symptoms are possible:
- headache;
- visual impairment;
- difficulty swallowing;
- nausea and vomiting;
- loss of control over urination and bowel movements;
- muscle pain and weakness;
- fatigue.
Sudden paralysis
If paralysis develops suddenly, seek medical help immediately. medical care. If you suspect a head, neck, or back injury, do not move the person unless their life is in danger, such as from fire or explosion. Wait until the professionals arrive.
To prevent further injury, stabilize the spine by keeping the victim's head in line with the body. To do this, use blankets, towels, and clothes, placing them on the sides, near the victim’s head and neck.
Do not give the victim anything to drink.
If you suspect a head, neck, or back injury, do not move the victim.
What doctors are doing
Emergency doctors immobilize the spine, take measures to reduce the pressure inside the skull, and administer oxygen. A breathing tube may be inserted into the patient.
Providing breathing
A ventilator may be used in the hospital. Research is being done to determine the cause of the paralysis.
Ensuring swallowing
If the cranial nerves that control eye movements, tongue movements, facial expression, swallowing, and other important functions are paralyzed, the patient may have difficulty swallowing. To avoid exhaustion, he is prescribed liquid and soft foods, feeding through a tube or intravenously.
Maintaining muscle tone and joint function
To maintain muscle tone in paralyzed limbs, the arms and legs must be subjected to special exercises daily.
To avoid abnormal joint position, called contracture, splints are placed on paralyzed limbs. Special devices are used if the patient cannot raise the foot and it hangs down.