Paralysis refers to the loss of muscle function and is usually accompanied by sensory loss in the affected area. It’s usually caused by damage to the central nervous system especially the spinal cord. Causes include stroke, trauma, nerve damage, polio, multiple sclerosis, etc. Paralysis can occur either partially or fully. Lower half paralysis is called paraplegia and paralysis of both arms and legs is called quadriplegia. It happens because the brain can’t send messages to the different parts of the body for various reasons. If the nerve fibres are damaged the paralysis is usually irreversible.
Statistics show 1 in 50 people globally have been diagnosed with some or the other kind of paralysis. Paralysis is mainly caused by the following conditions –
Stroke: Almost 30 percent of all paralyses are caused by stroke. Types of paralysis from stroke include –
- Hemiplegia or one sided paralysis
- Hemiparesis, that is, weakness or inability to move one side of the body
- Spasticity, meaning, stiff or tight muscles
- Dysphagia or trouble swallowing
- Foot drop or inability to raise the front part of the foot
Spinal cord injury: It is the second largest cause of paralysis after stroke. Spinal cord injury may occur because of work place accidents, motor vehicle accidents, sports accident, falls, birth defects, being a victim of violence, natural disasters, and many other known and unknown causes.
Multiple sclerosis: Multiple sclerosis is a chronic disorder of the central nervous system. Although MS does not always cause paralysis, most people affected with MS will need mobility aids such as wheelchairs or crutches because of fatigue, weakened muscles or balance problems.
Cerebral palsy: In simple words, cerebral palsy is brain paralysis. It is neurodegenerative disorder that occurs as a result of abnormal development or damage to the parts of the brain that control movement. As the name suggests, paralysis is a characteristic symptom of the disorder.
Post-polio syndrome: It is a condition that affects survivors of polio. The syndrome can occur years after initial polio attack. Muscle weakness, fatigue, and paralysis is a common symptom of the syndrome. The cause is unknown but experts opine that the syndrome can occur because of fatigue of overworked nerve cells or brain damage due to virus or combination of both and other factors.
Neurofibromatosis: It is genetic disorder that causes tumours to grow around the nerves. Paralysis may occur if the nerves are damaged. Usually the tumours are benign but they may turn malignant and cause cancer.
Traumatic brain injury: It is a brain injury that occurs when the head suddenly and violently hits an object, for example a motorbike accident or victim of an assault causing injury to the brain and resulting in partial or permanent paralysis.
There are other causes too but mainly the above mentioned ones are the main causes.
What may look like obvious symptom of paralysis may actually not be paralysis. Numbness, weakness in muscles or muscle cramps may ‘feel’ like paralysis but it is actually not so. It’s only the complete loss of muscle function that is construed as paralysis. Paralysis may affect either one side of the body or both sides, upper limbs, or just the legs, sometimes the whole body is paralysed except for the eyes. Usually paralysis are occur along with some of the following symptoms –
- Loss of consciousness (could be brief) or confusion
- Clumsiness and numbness
- Severe headache
- Difficulty breathing
- Cognitive difficulties, difficulty writing or speaking
- Changes in mood or behavior
- Loss of bladder or bowel control
- Loss or changes in vision and/ or hearing
- Nausea with or without vomiting
The first step in diagnosis of paralysis is physical exam by the doctor. Next the doctor will talk about the symptoms and family history. Diagnosing will not be difficult if the cause of paralysis is obvious, for example, paralysis after a stroke. If the cause is not obvious, then the physician will order specialized tests such as –
- CT scan (Computed tomography)
- MRI (Magnetic Resonance Imaging) scans
- Electromyography (usually used to diagnose Bell’s palsy)
- If required the patient will then be referred to a neurologist.
You may ask – are there chances of recovery from paralysis? The answer is – yes and no. Researchers and medical professional are confident that partial or even complete recovery is possible with some types of paralysis.
Whether it is paralysis from stroke, spinal cord injury, or polio, treatment and recovery techniques are similar. Treatment are usually aimed at restoring the brain-body connection.
For example, researchers at Southampton UK, with funding from the Stroke Association, have developed a wearable electronic device that helps recover arm function by delivering tiny electrical currents to the nerves thereby activating hand and arm muscles. This method is called Functional Electrical Stimulation or FES.
FES is already in use for recovery in lower legs and feet paralysis. In 2009, a study published in the journal Brain reported that electric pulse stimulation paired with assisted exercise program for 7 months enabled paraplegic subjects with zero-movement to regain a significant degree of leg control, allowing them to get up (stand) for some time without outside help.
New researches are looking for other ways to successfully treat paralysis. For example, neurology researchers at Johns Hopkins University of Medicine explored the possibility of replacing cells that were destroyed because of paralysis due to spinal injury. They could successfully restore functional motor units with embryonic stem cells in lab animals. Researchers around the world are now trying out this technique, called stem cell therapy, to restore lost motor function of spinal cord injury.
Studies found that recovery, partial or complete, was more difficult with advancing age. Older adults took much more time or even did not recover completely from paralysis because of other medical conditions including cardiac problems and diabetes. Although age did seem to be a factor in complete recovery or time taken to recovery in paralysis, especially spinal cord injury paralysis, the severity of the injury is the more significant predictor of recovery outcome.
If cure or recovery from paralysis is not possible, various mobility aids such as wheelchairs and orthoses are available for people with paralysis.
Seek treatment for associated symptoms such as bowel movement, neuropathic pain, and breathing difficulties.
Even if the paralysis is not cured, the quality of life of the patient can be improved greatly by managing paralysis wisely and consulting the doctor regularly.