What is Paralysis?
What is Paralysis? Paralysis is the loss of the ability to move one muscle of the body or more for a while or even permanently. Paralysis can be total, where there is no movement at all in the problem muscles, or only partially, which the muscles are still able to move but the movement is limited or weak. Paralysis can be focal on one part of the body only, or thoroughly, of all the muscles of the body. Paralysis can also occur suddenly or gradually, with or without preceded sensory disturbances such as tingling and numbness.
Causes of Paralysis
Paralysis can occur due to congenital or certain medical conditions. Injury can also be one reason someone becomes paralyzed, for example by accident or surgery.
One of the disorders that can cause paralysis is celebral palsy. Celebral palsy is a disorder of the brain, either due to a developmental interruption in the womb, or due to an injury to the brain during birth or after it. This disorder causes disruption in the child’s movement and coordination system. Cerebral palsy can be caused by several things, such as an infection during pregnancy, abnormalities in fetal brain growth, cerebral hemorrhage, premature birth, or difficult childbirth.
Other medical conditions that may cause paralysis include:
- Stroke. In stroke there is disruption of blood flow in the brain. Parts of the brain whose blood flow is disturbed will lack the oxygen and nutrients needed to work, resulting in damage to cells in the area, which then causes paralysis.
- Multiple sclerosis. Nerve damage due to abnormal reactions in the immune system that attacks the nerve protective membrane (myelin). This condition can disrupt the flow of signals sent from and to the brain.
- Brain injury. Injuries caused by a hard impact on the skull can damage blood vessels, muscles, and nerves in the brain. Generally, a person will experience paralysis on the left side of the body if damage occurs on the right side of the brain, and the right paralysis when the left brain is damaged.
- Spinal cord injury. The spinal cord is part of the body’s main nervous system, and it becomes the main nerve that channels signals to and from the brain and body as a whole. The degree of severity of paralysis that occurs will depend on the location of the injury or damage experienced. The closer to the neck, the more severe the condition. Under conditions of neck fracture, the patient may experience paralysis which can lead to lung function and respiratory muscles disturbed.
In addition, there are also some genetic disorders and other diseases that are rare but can cause paralysis, such as:
- Cancer, including brain cancer or cancer spread from other organs to attack the brain or spinal cord.
- Post polio syndrome, occurs when the polio virus damages motor neurons (motor neurons), which function for movement.
- Neurofibromatosis, a genetic disorder that causes tumor growth in the nerves, ranging from the brain nerve to the spinal cord.
- Motor Disease Neurons, a disease in which nerve cells in the brain and backbone degenerate and lose their function.
- Spina bifida, a congenital abnormality that affects the development of the spine and nervous system.
- Lyme disease, caused by a bacterial infection that is transmitted by ticks. At the time of sucking blood, the louse inserts bacteria into the blood that can cause nerve damage and temporary paralysis of the facial muscles.
- Guillain–Barre syndrome, an abnormal reaction of the immune system that attacks the peripheral nerves and causes inflammation.
- Friedreich’s ataxia, the body’s inability to produce the protein frataxin, the protein responsible for regulating the flow of iron in nerve cells, caused by mutations in the GAA gene. In this disorder occurs the accumulation of iron in the nerve cells that then cause cell damage.
Types of Paralysis
There are various types of paralysis that can attack the sufferer, among them are:
Focal and generalized seizures. Focal seizures are paralysis experienced in certain parts, such as one side of the face, hands, to the tissues and muscles of the vocal cords. Whereas, generalized seizures are paralysis experienced in whole body parts. Generalized seizures can be further divided into:
- Monoplegia. One member of the motion (arm or leg) experiences paralysis.
- Hemiplegia. There is paralysis of the limbs (arms and legs) on one side of the paralyzed body.
- Paraplegia. Both limbs, including the pelvic area or the lower half of the body, are paralyzed.
- Tetraplegia. Paralysis of the four limbs. This paralysis is also called quadriplegia.
Temporary and permanent disability. Temporary paralysis is paralyzed which may improve with or without treatment, after a period of time. Some of these include stroke and paralysis on one side of the face (Bell’s palsy). While permanent paralysis is a condition that is generally caused by severe injuries, such as a broken bone in the neck or a spinal cord injury. As the name implies, this condition will result in the sufferer experiencing permanent paralysis.
Partial and total paralysis. Partial paralysis is a condition where only some of the muscular and nervous functions are impaired or decreased. Whereas in total paralysis, muscle and nerve function disappear as a whole, the muscles can not be moved at all and the patient can not feel anything in the paralyzed part.
Spastic and flaccid paralysis. Spastic palsy is a condition in which the muscle member liggles or contracts out of control. Whereas in flaccid paralysis, limb muscles weakness without contraction and weak. One can experience these two paralysis gradually, starting with spastic or vice versa. This usually occurs in patients with cerebral palsy and motor neuron disease.
Symptoms of Paralysis
In general, people with paralysis will experience symptoms such as difficulty moving and controlling the movement of muscles, and feel a certain sensation. If the condition worsens, the patient may experience a tingling or numb sensation before experiencing total paralysis. The severity of the symptoms will correspond to the type of paralysis and injury suffered.
Diagnosis of Paralysis
Doctors will usually perform physical examinations such as assessing muscle movements and sensory abilities, as well as asking history of the patient’s illness as well as in the family. The following investigations may be suggested to know the type and severity of paralysis experienced:
- Photo Rontgen. To check for abnormalities in the bones, especially the spine and neck.
- CT scan. To examine the condition of bone and tissue in more detail, especially for cases such as head or spine injury.
- MRI. The usual scans are used to examine the muscles in more detail and detect any damage to the spinal cord or brain.
- Electromyography. To check the delivery of electricity to the muscles and nerves of the patient.
- Myelography. To check the condition of spinal cord fibers by using a special liquid as a contrast agent, which is injected prior to scanning.
Treatment of Paralysis
Most paralysis can not be cured, especially for those with total or permanent paralysis. However, treatment can be done to relieve symptoms experienced and facilitate the patient to live. Treatments that can be done include the provision of drugs, physiotherapy, surgery, to the use of tools for the motion.
Some examples of drugs commonly used in cases of paralysis are:
- Anticonvulsants, to relieve muscle spasms and stabilize neural activity in the brain. The usual anticonvulsant drug is pregabalin. Side effects that may occur after using this drug are drowsiness, dry mouth, excessive sweating, and vision problems.
- Tricyclic antidepressants, to relieve nerve pain and overcome depression in patients. The most commonly recommended drug is amitriptyline. If the patient experiences side effects such as changes in behavior or the desire to commit suicide, see a doctor immediately.
- Muscle relaxants. To relieve muscles that have chronic tension to seizures. Commonly recommended medications are baclofen, dantrolene, or tizanidine. Avoid sedative drugs during taking this drug.
In addition to drugs taken, doctors may advise botulinum toxin injections to stop brain signals passing through the paralytic limbs. Usually, this action will be performed in conjunction with physiotherapy to provide more optimal results.
Patients can also be given vaccinations such as flu vaccination and pneumococcal (PCV) when the ability to cough and remove mucus from the respiratory tract decreases. Usually, this condition occurs when paralysis of the abdominal and chest muscles.
Before taking any medication, make sure you know the possible side effects that can be experienced, including other medications that should be avoided during the treatment.
The doctor may suggest surgery if the treatment provided does not help. One of them is intrathecal baclofen therapy. In this action, the doctor will install a small pump outside the body and connect it with the spinal cord. This action is done to withstand nerve signals that can lead to stiff muscles and launch baclofen drugs to enter the nerves directly.
Operation action can also be done to help CHAPTER patient. The operation performed is a colostomy, by combining an artificial channel between the colon and the abdominal wall. If the condition is not too severe, non-surgical action can be performed to help the bowel and tuberculosis such as the installation of catheter tube in the urethra to facilitate the patient to urinate or encourage colon cleansing by injection of a special fluid through the anus or called enema.
Use of Tools
Most people with paralysis need tools to move from one place to another. Usually this can be done with the help of a manual or electric wheelchair, an orthosis buffer to stabilize paralyzed parts of the body (such as the arms, legs, and knees), to neuroprosthesis by using special electrodes to stimulate the movement of muscles through electricity.
Under certain conditions, the patient may be advised to perform physical therapy or occupation in order to launch activities that are usually done, though not maximal.
Consult a physician before choosing the right tool to adjust to your condition.
Treatment Related Diseases
Sometimes paralysis can trigger other health problems, such as the difficulty of coughing and breathing, especially if paralysis occurs in the abdominal muscles, chest muscles, and spinal cord.
If the patient has difficulty coughing, the doctor will usually suggest phlegm-thinning drugs, simple therapy by sitting in a certain position, consuming enough water, to avoid smoking. If unsuccessful, your doctor may trigger a cough with assisted cough technique. This technique is done by pressing the top of the stomach just below the ribs until the patient starts coughing. Make sure there is a pause between presses so that the patient can take a deep breath normally. Ask your doctor before doing this technique.
For those who have difficulty breathing, especially for people with spinal cord injury, the use of ventilator is often the main choice. There are two choices of ventilators that can be used, namely negative pressure ventilator and positive pressure ventilator. The negative pressure ventilator keeps the pressure inside the negative chest cavity, so that air from outside can flow in by itself. Positive pressure ventilators provide pressure to push air into the lungs through pipes inserted into the throat and trachea (invasive), or through the nose or the mouth (non-invasively).
If the ventilalor is unusable, the patient may be advised to use a special device called a phrenic nerve stimulator inserted into the chest through surgery. This tool will encourage electrical flow on the phrenic nerves that control the diaphragm muscles, so that the lungs can expand and deflate normally to fill the air.
Complications of Paralysis
Patients with paralysis may experience complications at some point, such as:
Depression. Paralysis can change a person’s life in a short time and 30 percent of patients will usually experience depression, especially for patients with total paralysis. Symptoms of depression that can be seen is denial of the condition, excessive anger, to do anything to achieve change. This will happen until the patient receives his condition and is willing to adjust his lifestyle. Generally, rehabilitation may help lower symptoms of depression to occur.
Decreased sex drive. Paralysis can affect a person’s ability and desire to engage in sexual activity, especially in men. However, there are several ways that can be done to help increase sex drive in crippled men, such as:
- Stimulates erections by touching sensitive parts, such as the penis or other limbs.
- Stimulate psychologically by showing a picture of sexual nuance or arousing the desire to have sexual relations through words.
- Ease the ejaculation process with a penile stimulation vibration tool that can be placed on the tip of the penis and stimulate the pubic nerve for 10 – 30 minutes. If successful, sperm can be transferred to a woman’s uterus through an intrauterine insemination process (IUI).
For people with paralysis of women, the biggest problem during sexual intercourse is the inability to produce natural lubricants in the vagina. This usually occurs in patients with spinal cord injury, due to the delivery of nerve impulses for lubrication function derived from these nerves. Ordinary artificial lubricants can be done by applying a water-based lubricant such as KY Jelly. Avoid using lubricants with a mixture of oils, minerals, paraffins and hydrocarbons (petroleum jelly) because it can cause irritation of the vagina.
Autonomic Disreflexia. Autonomic dyslexesis is a potentially life-threatening complication of brain bleeding, seizures, and death if not treated properly. This condition attacks the autonomic nervous system so that it can interfere with the regulation of blood pressure, gastrointestinal function, and respiratory tract. This complication is often experienced by patients with tetraplegia paralysis, or paralysis on both sides of the arms and legs. Symptoms usually seen in autonomic disrefleksia patients include severe dizziness, goosebumps, excessive sweating, rashes, swelling around the point of injury, chest tightness, hypertension, weakened heart rate, wide eyeballs, or anxiety. Generally these symptoms are triggered urinary tract infections or difficulty disposing of urine in the long term. Other conditions that can also be triggers include hemorrhoids, childbirth, sexual intercourse, abdominal cramps during menstruation, blisters or sores on old pressed skin (decubitus), broken bones, burns, or toenails that grow into the skin (cantengan ).