Paralysis is the complete loss of muscle function in one or more muscle groups in human body. Temporary paralysis is a paralysis that last a short time anywhere from a few minutes to a few months. There are several possible causes of paralysis and the major ones are stroke, trauma, poliomyelitis, amyotrophic lateral sclerosis, botulism, spina bifida, multiple sclerosis, and Guillain-Barr%26eacute; syndrome. Paralysis is most often caused by damage to the nervous system or brain, especially the spinal cord while the muscles themselves stay intact. Beside the motoric symptoms of paralysis, there are often also some sensorial symptoms such as loss of feeling in the affected area. The most common type of temporary paralysis is when muscles do not get the blood flow they need such as when sitting or sleeping with an arm or leg in a position that restricts the blood flow. Hysteria or a severe emotinal trauma may also cause paralysis.
Some characteristics of paralysis
Paralysis may be divided into three big groups:
%26bull; Localized - This is a very common form of paralysis which is usually caused by a stroke. Patients often have hemiplegia (weakness on one side of the body) or other patterns of paralysis depending on the area of damage in the brain by stroke.
%26bull; Generalized - This is a common form of paralysis in which patients with stroke may be weak throughout their body. It is also called global paralysis.
%26bull; The paralysis that follows a certain pattern
Common causes of paralysis
There are many possible causes of paralysis and the most common are:
Stroke
A stroke or a brain attack represents an acute neurological injury in which the blood supply to a part of the brain is interrupted by several possible factors.
The part of the brain which was left with disturbed perfusion can no longer receive adequate oxygen carried by the blood and this leads to the brain cells death, impairing the function of that part of the brain.
Risk factors include:
%26bull; age
%26bull; hypertension
%26bull; diabetes mellitus
%26bull; high cholesterol
%26bull; cigarette smoking
Poliomyelitis
Poliomyelitis is a viral paralytic disease caused by a virus called poliovirus. This virus enters the body orally, infecting the intestinal wall but it may enter the blood stream and get into the central nervous system causing muscle weakness and often paralysis. Young children who contract polio may sometimes suffer only mild symptoms which can make it hard to diagnose the condition. People who have survived polio sometimes develop additional symptoms, notably muscle weakness and extreme fatigue, decades after the primary infection. These symptoms are called post-polio syndrome.
Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis is a very progressive and almost invariably fatal neurological disease. Experts have discovered that, in Amyotrophic Lateral Sclerosis, both the upper motor neurons and the lower motor neurons are affected and they degenerate or die. When this happens, muscles are unable to function and they gradually weaken and waste away. More then 30,000 Americans have this disorder, and an estimated 5,000 cases of the disease are diagnosed in the United States per year.
Botulism
Botulism represents a rare but serious paralytic disease caused by a nerve toxin called botulin. This poison is being produced by the bacterium Clostridium Botulinum. It is a very serious and potent toxin which is capable of blocking the nerve function and causes the respiratory and musculoskeletal paralysis.
There are three main kinds of botulism:
%26bull; Food-borne botulism - caused by eating foods that contain the botulism toxin.
%26bull; Wound botulism - caused by toxin produced from a wound infected with Clostridium Botulinum
%26bull; Infant botulism - caused by consuming the spores of the bacteria, which then grow in the intestines and release toxin.
Spina bifida
Spina bifida is a term which means split or divided spine. It represents a birth defect caused by an incomplete closure of one or more vertebral parts of the spine, resulting in malformations of the spinal cord which fall into three categories:
%26bull; spina bifida occulta,
%26bull; spina bifida cystica
%26bull; meningocele.
Multiple sclerosis
Multiple sclerosis is a chronic, inflammatory disease that affects the central nervous system. Multiple sclerosis affects neurons and their cover called myelin causing various symptoms depending upon which signals are interrupted.
Guillain-Barr%26eacute; syndrome
Guillain-Barr%26eacute; syndrome is a rare immune-mediated inflammatory disorder of the nervous system. The pathologic mechanism of the disease is loss of myelin in peripheral nerves due to an acute inflammation. The cause of this inflammation is unknown. It is believed that it is an autoimmune disease, meaning that the sufferer's immune system is triggered into damaging the nerve covering.
Trauma to the spinal cord
When a person suffers a spinal cord injury, the spinal nerves joining the cord below the level of injury will generally be either completely or partially cut off from the brain resulting in Quadriplegia (paralysis usually affects the cervical spinal nerves resulting in paralysis of all four limbs) or Paraplegia- complete paralysis of the legs and abdomen up to the nipple line. Nerves joining the spinal cord above the level of injury will be unaffected and continue to work as normal.
Periodic or temporary paralysis
There is also one specific group of paralyses called periodic paralysis. Periodic paralysis is a group of rare genetic diseases that lead to weakness or paralysis from common triggers such as cold, heat, high carbohydrate meals, hunger, stress or excitement and physical activity. The underlying mechanism of these diseases are malfunctions in the ion channels in skeletal muscle cell membranes that allow electrically charged ions to leak in or out of the muscle cell, causing the cell to depolarize and become unable to move.
Types of periodic paralysis
Periodic paralysis is an inherited myopathy with significant variation in symptomatology, leading to a spectrum of familial phenotypes.
Specific diseases include:
Hypokalemic periodic paralysis
Hypokalemic periodic paralysis is characterized by a fall in potassium levels in the blood. This specific weakness may be mild and limited to certain muscle groups, or more severe and affect the arms and legs. Attacks may last for a few hours or persist for several days.
Hyperkalemic periodic paralysis
Hyperkalemic periodic paralysis is an inherited disorder which affects sodium channels in muscle cells and the ability to regulate potassium levels. This inherited condition is characterized by uncontrollable muscle twitching and muscle weakness or paralysis.
Paramyotonia congenita
Paramyotonia congenita is a rare congenital disorder which is characterized by a condition in which the muscles do not relax after contracting. The problem is caused by the nerves, not the muscles.
Andersen-Tawil syndrome
Andersen-Tawil syndrome is a rare genetic disorder which affects the heart. Symptoms are a disruption in the rhythm of the heart's lower chambers in addition to the symptoms of long QT syndrome. These changes disrupt the flow of potassium ions in skeletal and cardiac muscle, leading to the periodic paralysis and irregular heart rhythm.
Diagnosis
This group of diseases is unusually difficult to diagnose and in most cases patients report numerous wrong diagnosis and treatments that made them worse.
%26bull; DNA-testing
A DNA testing is available for only a half dozen common gene mutations, while dozens of known mutations are possible but are not routinely tested.
%26bull; Exercise EMG test
A properly performed Compound Muscle Amplitude Potential Test can provide an accurate diagnosis in more than 80% of cases.
Treatment
Treatment of the periodic paralyses usually includes:
%26bull; carbonic anhydrase inhibitors (such as Acetazolamide or Dichlorphenamide),
%26bull; supplemental oral potassium chloride-for hypo-cases or avoiding potassium for hyper-cases,
%26bull; thiazide diuretics to manipulate the amount of potassium retained by the kidneys,
%26bull; significant lifestyle changes including tightly controlled levels of exercise or activity
Prognosis
Prognosis can vary because the disability caused by paralysis can range from minor weakness to permanent muscle damage, inability to hold a normal job and use of a power chair. Fortunately, most people function fairly well with medicines and lifestyle changes.
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