-IBIS-1.5.0-
tx
nervous system
paralysis
diagnoses

definition and etiology

definition:
Loss or impairment of motor function because of a condition of the neural or muscular mechanism.

etiology:

• Spinal cord injury: Paralysis following a spinal cord injury may be temporary (concussion or contusion) or permanent (from lacerations or transection).
• Polio: This causes asymmetric flaccid limb paralysis or bulbar palsies without sensory loss.

signs and symptoms

signs and symptoms:
• history of accident/trauma or polio.
• The most serious injury, an acute transverse cord lesion, causes immediate flaccid paralysis that gradually changes into spastic paralysis over days or hours from an exaggeration of the normal stretch receptors. The paralysis occurs below where the cord was transected:
» Above C-5: Causes respiratory paralysis and is usually fatal.
» C4-5: Causes complete quadriplegia.
» C5-6: The arms can abduct and flex.
» C6-7: Paralyzes the legs, wrists and hands, though shoulder movement is normal and the elbows can flex.
» Above T-1: Causes miotic pupils.
» C8-T1: Causes Horner's syndrome.
» T11-T12: Affects leg muscles above and below the knees.
» T12-L1: Paralysis below the knee.

lab findings:
• CSF findings in polio will show increased protein and AST; these findings are also present in many viral CNS diseases
• check associated blood findings

course and prognosis

• Spinal cord trauma: Compressed nerve tissue will recover its function, although severed or degenerated nerve processes will lead to permanent disability. Any dysfunction remaining after 6 months will probably be permanent.

• Polio: Fewer than 25% of afflicted patients suffer permanent disability, 25% have mild disabilities, and greater than 50% recover with no residual paralysis.

differential diagnosis

• differentiate among the many causes of paralysis by clinical picture and etiology


footnotes