Paralysis is a term we all know or have heard about. However, few of us understand the term is more general and can include a variety of causes that may cause multiple presentations like short-term or long-term paralysis, localized (restricted to one area), generalized (applicable to a larger area of your body), partial (affecting a section of your body) or complete (with no conscious motor control over any muscles/muscle groups). 

Paralysis also differs in presentation. Some are flaccid, with muscles becoming flabby and shrinking, Others present as spastic where the muscles tighten up and cause uncontrollable jerks and spasms. 

Palsy means paralysis with tremors. Bell’s palsy is a temporary paralysis of the facial muscles. 

Body:

What are the types of paralysis?

Paralysis can be classified in multiple ways as we have seen above. The commonly used terms describe the area affected by it. They are:

• Localized 
• Generalized
  • Monoplegia - One limb has lost muscle control
  • Diplegia - Occurs on the same area on both sides of the body
  • Hemiplegia - Affects one side of the body (both limbs on the same side)
  • Paraplegia - Affects both legs and sometimes the torso
  • Quadriplegia - Involves all movements. Little or no movement from below the neck

What causes paralysis?

When something disrupts the nerve signals travelling from your brain and spinal cord to your muscles, paralysis occurs. Since the connections are not working, it is like disconnecting the internet cable from your computer. You may try to reach this page again, but it will not be available to you. Similarly, a paralyzed person becomes unable to control their muscles that lose their connectivity with the central nervous system. 

Some people are born with birth defects like spina bifida that cause paralysis. However, the most common causes include:

• Traumatic Injury (most common)
• Stroke
• Auto-immune diseases like multiple sclerosis and Guillain-Barré syndrome
• Cerebral Palsy 
• Injuries to the brain
• Amyotrophic lateral sclerosis (ALS) and other conditions that affect your nervous system
• Ticks and Lyme Disease
• Epilepsy - Todd’s Paralysis

What are the common symptoms?

• Partly or Entirely being unable to move a part or the whole of your body
• Loss of sensation (in some cases)
• Muscle cramps
• Tingling or numb feeling in the arms or legs

What tests may be done by the doctor?

• XRays to study bone injury
• CT or MRI to identify the type of stroke or brain or spinal cord injury
• Myelogram checks for spinal cord injuries
• Electromyogram to understand the level of electrical activity in your muscles
• EEG to understand the level of electrical activity in your brain
• Blood tests and Immunological tests to detect underlying illness
• Spinal Tap or Lumbar puncture is when the fluid in your brain and spinal cord called CSF (cerebrospinal fluid) is needed to check for signs of disease

How is paralysis managed?

The management depends on the type of paralysis and the causative factor. The chance of the paralysis getting better also depends on these factors. However, it is important to watch out for complications that may occur such as:

• Difficulty in breathing and coughing
• Chance of aspiration
• Chance of pneumonia
• Blood clotting problems and Deep Vein Thrombosis (DVT)
• Speech and Expression
• Swallowing
• Psychological issues like depression and anxiety
• Erectile dysfunction
• Sexual problems
• Changes in blood pressure 
• Cardiac problems
• Loss of control of bladder and bowel
• Pressure injuries (bedsores)
• Sepsis

Once the main causes and complications are addressed, it may be necessary to go through a long rehabilitation phase where different exercises attempt to help the patient slowly recover some or all of their lost functions. However, it is important to understand that while rehabilitation methods accelerate possible recovery, they can not address issues that are beyond recovery. Rehabilitative therapy may involve exercises as well as adaptive or assistive equipment to assist in performing basic tasks.

Conclusion:

Paralysis is a serious condition that involves long consistent care for the patient to assist with recovery. It is a path that the patient, caregivers and healthcare professionals need to travel together. It is important to stay safe and avoid the risk of serious brain or spinal cord injury by taking care of basic precautions like wearing helmets and seatbelts, driving safe etc.