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Paralysis - understanding causes, types, symptoms

Paralysis - understanding causes, types, symptoms

Paralysis can be quite scary, but understanding it will help you cope with the its sudden onset and prevention.

Written by Mita Majumdar |Updated : May 22, 2014 10:56 AM IST

ParalysisLiu Yan, one of China's top classical dancers, was to perform in the Olympics' opening ceremonies. During rehearsals, the show's only solo number, she missed a jump to a malfunctioning platform, falling 10 feet. She dislocated her 11th vertebra, losing all feeling below the waist. She underwent six hours of surgery, but doctors say it is unlikely she will ever walk again since she was most likely paralysed. 'I never imagined I could suffer such a tragedy,' she said. 'I hope one day I can just stand up like a normal person.' In this post, we attempt to make some concepts about paralysis more clear for you.

What is paralysis?

Paralysis is a condition in which the muscle loses its capacity to function in a part of the body. This makes that part immobile. Muscle in itself is not responsible for paralysis. Muscles are controlled by the nervous system (nerves, spinal cord, and brain) which processes messages to and from the brain and other parts of the body. So, basically, paralysis happens when there is some sort of nerve damage, that is, either there is a problem with any nerve or when a portion of the spinal cord is injured.

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The human spine is made up of 24 vertebrae. The extent of the paralysis normally depends on how high up in the spine the injury occurs. For example, a person with an injury in the neck (C1-C4) will be paralysed from the neck below and can move only their head or maybe even the shoulders. In the same way, a person with a middle back, spinal cord injury will have fully functional muscles in the top half of their body but will be paralysed in the lower half (legs) thus needing a wheelchair. (Read: Imran Khan's spinal injuries: How serious are they?)

Read more about causes, symptoms, diagnosis and treatment of paralysis.

Understanding terms related to paralysis

Paralysis can be localised or generalised, temporary or permanent, partial or complete, and spastic or flaccid.

Localised paralysis

  • Facial paralysis limited to one side of the face
  • Paralysis of the hand
  • Paralysis of the vocal cord (the person may be able to speak but their voice will be hoarse)

Generalised paralysis

  • When only one limb (arm or leg) is paralysed, it is called monoplegia.
  • When the lower half of the body including both legs becomes paralysed, it is called paraplegia.
  • When both hands and legs become paralysed, it is termed quadriplegia.
  • When one side of the body (face, arm, and leg) is paralysed, it is called hemiplegia.

Temporary paralysis

  • Temporary facial paralysis as in Bell's palsy
  • Paralysis after a stroke in some cases

Permanent paralysis is caused by a serious injury, for example, a broken neck.

When a person has some function of muscles and sensation, for example, there is movement in one leg but not in the other, it is called partial paralysis.

When a person has no function of muscles and sensation, it is called complete paralysis.

Spastic paralysis occurs when the muscles are unusually stiff or have involuntary muscle contractions (spasms), for example, spastic paraplegia.

Flaccid paralysis is a type of paralysis where the muscles become floppy and weak and shrivel gradually.

Brain injury during birth or faulty brain development in the foetus causes a paralysis called cerebral palsy.

When the muscle tissue of the arms and legs deteriorates causing progressive weakness, it is called muscular dystrophy.

When the muscle cannot contract because of chemical malfunction in the nerves causing paralysis, the condition is called myasthenia gravis.

What causes paralysis?

Accidents, poisoning, infections, blocked blood vessels, and tumours can all cause paralysis. However, there are four main causes:

Stroke: Paralysis in stroke happens when the blood supply to the brain is disrupted or stopped. The blood carries oxygen and nutrients that the brain needs to function properly. The blood supply is stopped either when there is a blood clot or when a weakened blood vessel bursts.

Head injury: When a part of the brain that controls specific muscles is damaged because of head injury, paralysis occurs.

Spinal cord injury: The spinal cord is a part of the central nervous system and its function is to transmit signals to and from the brain and other parts of the body. When the spinal cord is damaged because of the neck or spine injury, the brain cannot transmit signals to the muscles resulting in paralysis. Accidents, falls, and even certain disease can cause damage to the spinal cord.

Multiple sclerosis: When there is interruption of communication between the brain and the muscles because of inflammation that scars the nerves, it results in a paralytic disease called multiple sclerosis.

Who is at risk for paralysis?

Though generalizations cannot be made about the risk for paralysis, in certain cases, family history, ethnicity and pre-existing conditions can affect the risk.

Some people are more prone to Bell's palsy (temporary facial paralysis) than others, that is, people who have a family history of Bell's palsy, have the common cold, diabetes, influenza, or those who are in the third trimester of pregnancy.

Similarly, older adults, south Asian or African nationalities, people with high blood pressure, high cholesterol and diabetes, or those who are overweight are more likely to experience a stroke.

Again, people with osteoporosis are more prone to spinal cord injury or paralysis due to a fall.

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