Paraplegic

Introduction

Interpretation Paraplegia refers to a condition in which the limbs, the movement, the reflex, etc., and the loss of the bladder and anal sphincter function are lost after the injury of the thoracolumbar spinal cord. It is caused by direct operation (such as firearms, knife stab wounds, etc.) and indirect operation (spine fracture, dislocation, etc.), but also due to the invasion of certain diseases by the virus into the central nervous system. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: Acne

Cause

Paraplegic cause

Paraplegia caused by tuberculosis (20%):

The history of the original spinal tuberculosis or the symptoms of tuberculosis, the lesions mostly occur in the thoracic or cervical vertebrae. The course of the disease is slow, and it is often characterized by spastic paralysis. The limbs or lower limbs are weak, hard and stiff, and the affected area may have kyphosis or lateral deformity. The spinous process gap is not widened. X-ray films show that the vertebral body has osteolytic damage. The intervertebral space is narrowed or disappeared, and the vertebral bodies may have mutual embedding, and there is an abscess shadow on the paravertebral. ESR increased.

Tumor-induced paraplegia (20%):

More common in vertebral hemangioma, vertebral giant cell tumor. 1 vertebral hemangioma: more common in older women, occurs in the chest or waist single or multiple vertebral bodies. The early symptoms are local dull pain or banded pain, paresthesia, and slow course. The X-ray film showed that the vertebral body was thickened in the longitudinal direction, with a strip-shaped density reduction zone, which was fence-like or multi-capsule compressed. 2 vertebral giant cell tumor: more common in young and middle-aged, early local intermittent pain, localized tenderness, limited mobility and paraplegia. X-ray films showed that the vertebral body showed a soapy shadow or osteolytic changes, and the trabecular bone was incomplete.

Paraplegia caused by metastasis (10%):

Have a history of primary tumor treatment (cervical cancer, breast cancer, prostate cancer, lung cancer, thyroid cancer, etc.). Paraplegic symptoms gradually appear and the course of the disease is slow. The striate showed that the vertebral body was consistently squeezed before and after, with osteolytic or worm-like destruction, osteogenic spots and block hardening images, or mixed images of osteogenic and osteolytic forms. There is no significant change in the upper and lower intervertebral space.

Paraplegia due to trauma (40%):

Spinal fractures or fractures - dislocations damage the spinal cord or cauda equina, the nerves are damaged and cannot function properly.

Prevention

Paraplegia prevention

Avoid injuries in your daily life.

Complication

Paraplegia complications Complications

Acne, infection.

Symptom

Paraplegia symptoms common symptoms, movement disorders, anal canal reflexes, sensory disturbances, reflexes, knees, reflexes, disappearance

Clinical features

(1) Characteristics of upper motor neurons: Because the cortical motor area and the descending pyramidal bundles dominate the muscle group intensively, the lesion often leads to the entire limb paralysis (monoplegia, one side limb), one side limb paralysis (hemiplegia, hemiplegia ); bilateral lesions can cause paralysis of the lower extremities (paraplegia) or quadriplegia. Increased muscle tone of the affected limb, hyperreflexia, weakened or disappeared shallow reflex, pathological reflex, no muscle atrophy and fasciculation, but disfigured muscle atrophy after long-term sputum. The electromyogram showed normal nerve conduction velocity and no denervation potential.

Acute severe lesions such as acute stroke and acute myelitis, due to the sudden interruption of the pyramidal tract, the spinal cord shock period, the muscle stretch reflex is inhibited by soft palate, and the tendon reflex is reduced or disappeared. After several days or weeks, the stretch reflex is restored, and the muscle tension is increased and the tendon reflex is hyperthyroidism. The length of the shock period depends on the degree of damage and complications such as infection. Because the muscle spindle is more sensitive to stretch reflex than before the disease, especially the upper limb flexor and lower extremity extensor muscles have higher muscle tension. The initial resistance is large, and the resistance decreases rapidly afterwards, which is a clasp-knife phenomenon.

(2) Characteristics of lower motor neurons: muscle muscle tension decreased, tendon reflexes weakened or disappeared (lower motor neuron damage interrupted single synaptic stretch reflex), early muscle atrophy (about several weeks) appeared (anterior horn Muscular dystrophic dysfunction of the cells, visible fasciculation, no pathological reflex. Electromyography showed decreased nerve conduction velocity and denervation potential.

Lower motor neuron lesions are caused by one or several adjacent spinal nerve roots, peripheral nerves or plexus lesions, often only invading a certain muscle group, causing partial muscle spasm or single limb paralysis; multiple nerve roots or neuropathy It can also cause quadriplegia such as Guillain-Barr syndrome.

Examine

Paraplegic examination

The necessary selective laboratory tests include: blood routine, blood electrolytes, blood sugar, and urea nitrogen.

The necessary optional auxiliary inspection items include:

1. Examination of the skull base, CT and MRI.

2. Cerebrospinal fluid examination.

3. Chest, ECG, ultrasound.

Diagnosis

Paraplegia diagnosis

Paraplegia refers to a condition in which the bilateral limbs feel sensation, movement, reflex, and the loss of bladder and anal sphincter function after the injury of the thoracolumbar spinal cord.

Cervical spinal cord injury often causes quadriplegia.

Among them, those who have completely lost the above functions, called complete paraplegia, and some functions exist, said incomplete paraplegia.

In the early stage, it is a flaccid paralysis. After about 3 to 4 weeks, it gradually turns into a sputum.

The cause of paraplegia is related to spinal cord trauma or its own pathology.

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