Whether it is by an inherited gene or because of a viral infection, partial paralysis of the extremities can be a terrifying condition.
Paraparesis involves the limited movement of the lower limbs, and unfortunately, there is no cure. This neurological disease is seen mostly in those between the ages of 20 and 40, but there are reported cases in young children as well. But, what is paraparesis? To answer this, we need to take a closer look at this condition and learn about paraparesis types, as well as the symptoms involved.
Also known as spastic paraplegia, paraparesis causes a miscommunication in the neurons that control the movement of the legs from the pelvic region. Stiffness, weakness, and partial paralysis are the key effects of this progressive disease. Some cases can also include the inability to urinate and have bowel movements. Since the nerves of the pelvic area attached to the spinal cord are affected, this condition can also influence speech and swallowing.
Paraparesis Types
There are two forms of paraparesis which further explain the primary causes of the disease.
1. Heredity Spastic Paraplegia
This type of paraparesis is known as familial spastic paraparesis, as develops from an inherited gene. The nerves of the carrier or parent increasingly deteriorate over time, causing the muscles to become weak and numb. This condition is then passed along to the child, resulting in the paralysis.
2. Tropical Spastic Paraplegia
This second type of paraparesis occurs as a result of a spinal cord viral infection. The human t-lymphocytic virus invades the spinal cord nerves, gradually damaging nerve function over time. As the name implies, tropical spastic paraplegia is commonly seen in warmer regions or after a visit to a tropical area.
Paraparesis Causes
The causes of paraparesis are highly dependent on the specific type of condition, either heredity spastic paraplegia or tropical spastic paraplegia. The underlying causes of these conditions are damage to the nerves by genetics or by an infection. The infection can be a result of trauma to the spinal cord such as an accident.
Paraparesis progressively worsens, leading to a lifetime of partial paralysis, and the use of a wheelchair.
Paraparesis Symptoms
In most cases, the disorder presents no symptoms in the early stages. The signs and severity are unique to the underlying cause behind it. The ability to walk can be affected, and in rare instances, it can impair vision and memory function.
With hereditary spastic paraplegia, the symptoms begin with muscle spasms in the legs leading to walking difficulties. It then progresses overactive reflexes, which causes the muscles to contract and change sensation. It can lead to cognitive problems and issues with vision, memory, and thinking patterns.
Tropical spastic paraplegia, on the other hand, causes weakness to set into the legs, followed by the inability to control the bladder and bowels. As a result, men can suffer from erectile dysfunction.
The motor function of the hands and arms can also be affected. Changes to the nerves begin to affect sensation.
Paraparesis Diagnosis
There are several tests required to diagnose either type of paraparesis. For example, a neurological examination in the form of a Glasgow Coma Scale test is used to measure any diminishment of conscious-level brain function, as well as a test for restless leg syndrome.
A magnetic resonance imaging (MRI) scan checks for any damage to the spinal cord or inflammation of the spinal cord. And a lumbar puncture determines if a virus has invaded the nerves.
Paraparesis Treatment
Paraparesis is a lifelong condition with no cure. Treatment is designed to combat symptoms of pain and muscle spasms. It may include medications such as anti-inflammatory drugs, corticosteroids, muscle relaxers, pain relievers, antispasmodic drugs, and antidepressants. Bladder and bowel control issues may also be treatable with medication.
If necessary, it is also important to target the affected extremities with physical therapy, range of motion exercises, and water and speech therapy. Doctors may recommend occupational therapy, as well as electrical stimulation to treat muscles.
The use of a walker, cane, pelvic braces, shoe inserts, and even a wheelchair can benefit mobility.
Other treatment options include special diets for eating difficulties and an increased intake of beta-carotene, vitamin E, and creatine. Some may also benefit with yoga, massage, chiropractic methods, and acupuncture.
Paraparesis Exercises
There are three forms of important exercises and stretches to perform on a regular basis. They will help to maintain the use of the extremities and muscles.
1. Stretching Exercises
Stretching the muscles and maintaining flexibility may increase or keep a stable range of motion. It is important to slowly and gently lengthen the muscle to target muscle spasms, and possibly prevent bursitis and tendonitis.
Begin by slowly stretching as much as you can, and hold for 10 seconds before returning to a regular stance. Perform this stretch at least once each day. Always stretch before and after attempting any form of exercise.
2. Aerobic Exercises
After a good stretch, perform a suitable aerobic exercise you enjoy to ensure you get the maximum benefits. Any form of aerobic exercise will help increase the intake of oxygen, as it improves your lungs and heart muscle. At the same time, it boosts energy levels, helps maintain a healthy weight, promotes happiness, and improves sleep patterns while alleviating any fatigue.
Perform one of the following exercises and remember to warm-up with stretching exercises for five minutes, and then cool-down for a five- to 10-minute period.
Walking is one of the best exercises, whether it be slow and steady, or more of a fast-paced walk.
Aqua exercises are gentle on the body while providing amazing benefits. It removes the effects of gravity to increase range of motion. The weak muscles and tender joints as a result of paraparesis may be alleviated in warm water. Use a floatation device to support your body if you choose to perform the water exercises in deep water, as opposed to shallow water where sitting is easy.
Stationary cycling allows you to exercise in any weather. It relieves any stress on the knees and pelvic region that may occur with other forms of exercise.
Perform chair exercises can help in those situations where you have trouble standing for prolonged times. Stretching and strengthening exercises can still be done.
3. Strengthening Exercises
Performing strengthening exercises may help the muscles improve in mobility and strength. It boosts energy and makes you feel emotionally and physically powerful. By maintaining or increasing muscle strength, posture may improve, the pain will be alleviated, and daily activities may be easier to carry out.
Paraparesis can be a frightening diagnosis. It is a lifelong condition resulting in the gradual reduction of mobility and use of extremities. Whether the cause is an infection or an inherited gene, this disease progressively gets worse as the symptoms develop.
Medication and various physical therapies can address the issues of paraparesis. It is important to focus on maintaining and improving the ability to continue to have range of motion and gait during the illness. This may be achieved with stretching, as well as aerobic and strengthening exercises.
Sources:
“Paraparesis – Causes, Symptoms And Treatment,” Daily Fitness Tips 4 U; http://www.dailyfitnesstips4u.com/paraparesis-causes-symptoms-treatment.html, last accessed July 12, 2017.
Spastic Paraplegia Foundation; http://sp-foundation.org/understanding-pls-hsp/treatments-therapies-pages/physical-therapy-and-exercise.html, last accessed July 12, 2017.