Summary about Disease
Paraplegia is a form of paralysis that affects the lower half of the body, including the legs and sometimes the abdomen. It results from damage to the spinal cord or brain, disrupting the communication between the brain and the lower parts of the body. This leads to a loss of motor function and sensation below the level of the injury or lesion. Paraplegia can be either complete or incomplete, depending on the extent of the damage.
Symptoms
Loss of voluntary movement in the legs.
Loss of sensation (touch, pain, temperature) in the legs and lower body.
Bowel and bladder dysfunction (incontinence or difficulty with elimination).
Sexual dysfunction.
Muscle spasms or spasticity.
Pain, which may be chronic and neuropathic (nerve-related).
Changes in reflexes.
Causes
Spinal Cord Injury (SCI): Traumatic injuries like car accidents, falls, sports injuries, or violence are the most common causes.
Spinal Cord Diseases: Conditions like multiple sclerosis (MS), transverse myelitis, spinal stenosis, tumors, or infections can damage the spinal cord.
Congenital Conditions: Birth defects like spina bifida can lead to paraplegia.
Stroke: A stroke affecting the spinal cord can cause paralysis.
Vascular Issues: Problems with blood supply to the spinal cord can cause damage.
Infections: Certain infections like polio or some types of meningitis can affect the spinal cord.
Medicine Used
The medications used in paraplegia are aimed at managing symptoms and complications, not curing the paralysis itself. These can include:
Pain Medications: Opioids, non-opioid analgesics, and neuropathic pain medications (e.g., gabapentin, pregabalin) for pain management.
Muscle Relaxants: Baclofen, tizanidine, or diazepam to manage muscle spasms and spasticity.
Bowel and Bladder Medications: Medications to manage bowel and bladder dysfunction (e.g., stool softeners, laxatives, anticholinergics).
Antidepressants: For treating depression, which is common in individuals with paraplegia, and can also help with pain management.
Anticoagulants: To prevent deep vein thrombosis (DVT), a risk due to reduced mobility.
Antibiotics: To treat infections, such as urinary tract infections (UTIs) or skin infections.
Is Communicable
Paraplegia itself is not communicable. It's not an infectious disease and cannot be spread from person to person. However, some of the causes of paraplegia, such as certain infections like polio, *are* communicable. If paraplegia is caused by an infection, it is the infection that is communicable and not the paralysis itself.
Precautions
Precautions focus on preventing complications and maintaining overall health:
Skin Care: Regular skin checks to prevent pressure sores (bedsores). Turning and repositioning frequently.
Bowel and Bladder Management: Following a bowel and bladder program to prevent complications like constipation or UTIs.
Respiratory Health: Deep breathing exercises and cough assist techniques to prevent respiratory infections.
Physical Therapy: Regular exercise and stretching to maintain muscle strength, flexibility, and range of motion.
Nutrition: Maintaining a healthy diet to support overall health and prevent weight gain.
Fall Prevention: Modifying the home environment to reduce the risk of falls.
Prevent Blood Clots: Medications and compression stockings.
Mental Health: Seeking support for depression, anxiety, or other mental health issues.
How long does an outbreak last?
Because paraplegia is not communicable, the term "outbreak" is not applicable to the condition itself. The onset of paraplegia is determined by the underlying cause.
How is it diagnosed?
Neurological Examination: Assessing motor function, sensation, reflexes, and coordination.
Imaging Studies:
MRI (Magnetic Resonance Imaging): To visualize the spinal cord and surrounding tissues, identifying injuries, tumors, or other abnormalities.
CT Scan (Computed Tomography): Can be used to evaluate the bones of the spine and detect fractures or dislocations.
Electromyography (EMG): To assess the electrical activity of muscles and nerves.
Myelogram: X-ray or CT scan after injecting contrast dye into the spinal canal.
Spinal Tap (Lumbar Puncture): In some cases, to analyze cerebrospinal fluid for signs of infection or inflammation.
Timeline of Symptoms
The timeline of symptoms depends heavily on the cause of the paraplegia:
Traumatic Spinal Cord Injury: Symptoms are typically immediate, with sudden loss of motor function and sensation below the level of the injury.
Spinal Cord Diseases (e.g., Multiple Sclerosis): Symptoms may develop gradually over days, weeks, or months. The onset can be relapsing-remitting or progressive.
Spinal Cord Tumors: Symptoms may develop gradually as the tumor grows and compresses the spinal cord, potentially over months.
Infections: Symptoms might appear rapidly (over days) and may involve fever, headache, and neurological deficits.
Important Considerations
Rehabilitation: Comprehensive rehabilitation programs are essential to maximize independence and improve quality of life. These programs include physical therapy, occupational therapy, and vocational rehabilitation.
Assistive Devices: Wheelchairs, braces, walkers, and other assistive devices can help individuals with paraplegia maintain mobility and independence.
Psychological Support: Dealing with paraplegia can be emotionally challenging. Psychological support, counseling, and support groups can be beneficial.
Long-Term Care: Paraplegia can require ongoing medical care and support. Long-term planning is important to ensure that individuals have access to the resources they need.
Secondary Complications: Individuals with paraplegia are at increased risk for secondary complications such as pressure sores, UTIs, DVT, and respiratory infections. Preventing and managing these complications is crucial.
Home Modifications: Changes to the home environment may be necessary to improve accessibility and safety.