Paraplegia is a paralysis, provoked by pathology, trauma. With it, the upper extremities, the lower extremities, are affected. Proceeding from this, the upper paraplegia, the lower one, is distinguished.
The disease affects both the lower(upper) extremities. It is usually provoked by disorders of the spinal cord. The most common reason, according to statistics, is car accidents. Much rarer, but still there is paraplegia of the lower extremities, the upper ones, provoked by diseases of the spinal cord, spine.
There is a subdivision into two types:
- paraplegia caused by a spinal injury in the lower part;
- tetraplegia, provoked by injuries of the upper spine.
With the last paralyzed, there are four limbs. The upper isolated also exists, but is extremely rare. It can lead to tumors, pinpoint hemorrhages.
Paraplegia is a pathology, most of itaffected by which wheelchairs are used. Visible defects are not the only ones that accompany the disease. Acquired and hereditary spastic paraplegia are associated with a large number of violations of the internal systems of the body.
The disease provokes damage:
- spinal cord;
- ponytail of the spine;
- nerve roots.
Risk groups are men aged 15-45 years, that is, people who are more likely to fall into transport accidents. In addition, there are hereditary paraplegia, provoked by genetic factors.
Paraplegia is a disease accompanied by the following symptoms:
- impaired movement;
- pain syndrome;
- problems with breathing;
- disrupting the functioning of the reproductive and urinary systems;
- dysfunction of sphincters;
- vegetative, sensory disorders.
Problems with movement
Paraplegia is a disorder in which movementbecome practically or completely impossible. How much paralysis affects the body depends on the extent of the injury. In some cases, homogeneous paraplegia is diagnosed when the spread occurs symmetrically with respect to the spine. There are also uneven violations. It depends on which part of the spinal cord is under attack.
In trauma, neural connections collapse, resulting inmovements can sometimes be observed spontaneous and even violent. Muscle tone becomes elevated, which is the most susceptible to flexors. If a person tries to unbend a limb, this leads to a worsening of the situation. Upper, lower paraplegia is characterized by spasticity. If the nerve roots have suffered, the likelihood of hypotension of the muscles is high. In this case, low paraplegia is diagnosed.
When the injury is received, the sensitivity of the skin is disturbed. In this case, suffer:
- the ability to perceive pain;
- a sense of touch;
- feeling of temperature.
Sensitivity is generally violated.Those sensations that are unusual for healthy people, which provoke the upper, lower paraplegia, are called paresthesia in science. If this reflects a loss of sensitivity, a person can easily get injured or burned and does not even notice that it happened. If sensitivity is lost completely, the probability of decubitus is high, since the disorder is accompanied by trophic disorders.
The sensitivity of the body allows a healthya person understand what position in space he occupies, what pressure is exerted on him, how great is the shear force. In disorders caused by paraplegia, this feeling is disturbed, so people with lesions of the lower extremities can understand what position those occupy, only if they look at them. To use your hands, you need to look at them. Simultaneously, balancing difficulties arise, since the abdominal press is also paralyzed. Patients who are diagnosed with paraplegia, complain of dizziness, are afraid of heights.
Pain syndrome with paraplegia
Both acquired and spastic paraplegiaStruma is characterized by a persistent pain syndrome. When an injury occurs, it appears immediately, but it persists for life. Pain can occur in those parts of the body where sensitivity is not disturbed, but also affects areas that have lost sensitivity.
Damage to the spinal cord means that the nervesfibers function incorrectly, and the brain receives distorted information that does not correspond to reality. Some data channels are completely blocked.
The pain syndrome in pathology strongly affects thepeople, becomes the cause of depression, reduces the quality of life, provokes regular stress, anxiety. In some, the syndrome appears, then disappears, then again returns, in others it is permanent. Often it is through pain that you can put the final diagnosis - for example, to identify problems of skin, intestine, bladder. In some cases, the pain is provoked by fatigue, stress and even emotions. Medicine knows of numerous cases when the force of pain was influenced by the change in temperature in the room.
Spastic paraplegia is manifested in:
- pressure jumps;
- deformation of the bladder;
- skin problems;
Possible violation of the body's temperature balance, provoked by the incorrect functioning of the coronary vessels. Sweating is characteristic of areas below the injured zone.
What can you expect if you wereis paraplegia diagnosed? Treatment in our day, unfortunately, as such does not exist. Once the trauma has been received, it is necessary to direct efforts on elimination of sharp consequences. As a rule, the patient is operated on, the fractures are eliminated, the general condition of the organism is assessed, the spinal cord is studied, the scale of the lesions and their nature are revealed.
Then the stage of rehabilitation begins.At this time, doctors help the patient restore body functions, as far as possible. Relative to the muscles located below the injured zone, control of residual functions is introduced. For residual areas of the lesion, the residual force potential is estimated. This helps to choose the best exercises, procedures aimed at teaching a person to serve themselves. Of course, even the most effective rehabilitation shows results even in the distant future.
Additional stages of treatment
If in the first time after receiving an injurythe patient was ill with a respiratory disease, it is necessary to organize artificial ventilation of the lungs. After a while, create postural drainage, teach a person to cough. Apply specialized techniques developed for patients with paraplegia. In the future, you will have to do this regularly.
Another effective technology iskinesitherapy. Such a technique is designed to allow the patient's joints to move again. It involves working with the affected area. The main task of the doctor is to prevent muscle contractions, leading to limited mobility. In addition, they work on strengthening the muscles.
The treatment is quite routine, it is based on the patient's capabilities and over time suggests a set of a wider range of tasks. Start:
- learning to lift yourself out of bed;
- taking a pose in a wheelchair;
- keeping the balance in a sitting position;
- sitting alone;
- steering wheelchair.
When paraplegii give a disability. These people require regular care and help, and it is on this depends on the duration of life. If the procedures are medical, medical are carefully observed, then a person will be able to live long enough. But the first complications of a hygienic nature lead to numerous complications, infection and inflammation of internal systems and organs, to trophic problems, which can provoke sepsis. Once infection becomes generalized, the risk of death is increased.
Paraplegia Stryumpel is a disease that relates to:
With her pyramidal spinal pathways are amazedfrom two sides. This disease is caused by genetic preconditions: it is inherited. In most cases, the inheritance of a spastic subspecies occurs according to a recessive type, but there is a likelihood of a dominant one. The disease is severe. But pure paraplegia is usually transmitted by the dominant gene. It is assumed that there are some pathological genes that provoke family pathology. It is suggested that it is from these genes that at what age the disease begins to develop.
With paraplegia of the Stumppel, the pyramidal lateralthe ways are reborn with time. Simultaneously, changes take place in Gaull's beams. The cerebral cortex suffers. The disease is heterogeneous. Stryumpel described in his works a spastic family subtype of the disease, which is very rarely documented in practice. Much more often observed spastic paraparesis, in which the affected area - the lower extremities. In these cases, spasticity prevails over paresis. The science of our days finds the cause of the disease in the sixth field of the cerebral cortex, where the extrapyramidal fibers begin.
Development of the disease
Family paraplegia usually begins at allunnoticed. At first, a person notes that the legs quickly and strongly become tired, eventually feels that the limbs move as if tight. Muscle tone grows, which is reflected in the reflex movements of the tendons. Often observe Babinsky's reflex.
Progression of the disease shows the clones of the feet,of the knees. Further, other limb infringements are diagnosed. The tonus builds up very much, the muscles weaken, but there is still no paralysis as such. A person's gait changes, it becomes "spastic". Joints are deformed, their contours are changed, while protective reflexes are provoked.
In most cases, patients remainskin reflexes, pelvic organs can function. The level of intelligence does not change, a person can coordinate his movements and does not fix any violations of sensitivity. But after some time, the upper limbs are involved in the negative process. This does not happen in 100% of cases, but there is a possibility of such development. Muscle tone grows in the hands, tendons are reflexively contracted, pseudobulbar symptoms are not uncommon.
Misfortune never comes alone
Very rarely there are such cases whenspastic paraplegia appears by itself, without being accompanied by other disorders. Usually other internal systems suffer. Very often, with paraplegia caused by genetic preconditions, the ataxia transmitted by inheritance is also diagnosed. There is a connection between paraplegia and amyotrophic syndromes. But even to this day, doctors do not know whether the diseases are phenotypic in relation to one process or are provoked each with their own genome.
Often, paraplegia is accompanied by atrophynerves responsible for vision, weakness of external eye muscles, nystagmus and dysarthria. When pathology fixes mental changes, epilepsy, hyperkinesia, intentional trembling.
Pathology and age
There is no exact information as to whichage spastic paraplegia affects a person who has a hereditary predisposition to her. Studies were carried out among patients with regard to family membership, which allowed doctors to establish accurately: even if we are talking about relatives, the disease still appears at different ages, there is no similarity. In some, the first manifestations are noticed immediately after birth, in others, pathology is found in the middle, older age.
If it is a matter of pure paraplegia, thencertain statistics can be said: the risk group is 10-20 years old. The disease is very slow, but still its progress is felt. Often patients live long enough, even live to old age. There are cases of increasing symptoms and provoking the disease with infections.
The disorder is associated with the lesion of the neurons responsible for the movement. The reason may be:
Sluggish paraplegia is characterized by a slow,gradual, steady decline of reflexes. Suffer in the first place tendons, but over time the process expands. The muscles decrease in size, the electrical excitability decreases. The most accurate method of detecting the disease is an electromyogram.
At languid paraplegia, atony is possible. In most cases, this development indicates a fracture of the spinal cord almost completely (or completely). The pelvic organs lose their capacity for work, it is impossible to move the body below the affected area. But there is another option. If the pathology is sudden, it did not have the prerequisites, perhaps the reason in the diaschisis, when the neurons temporarily cease to function.