Paraparesis : Causes, Picture, Symptoms and Treatment

Paraparesis is partial paralysis happen to both legs. This disease also refers to the defect of legs and hips. It is different from paraplegia which is a total loss of legs movement called paralysis.

Partial paralysis is a wide range of leg injuries and muscles functions loss. It happens when the message between the nerves and the brain is unclear. It can remain partial or lead to complete paralysis. This disease can occur in both side and one side of the body.

There is no treatment for paraparesis. But you can reduce its symptoms. Paraparesis doesn’t impact on life expectancy.

Causes of Paraparesis

As I have written above, this disease occurs by virus infection on the spinal cord or genetic cause. People may get this infection if nerve injury happens during an accident. This infection progress with time and get worse. Later it causes limbs and hands weakness. It will restrict the patient to be in a wheelchair. It is essential to consult a physiotherapist after getting initial sings. The doctor will advise on how to manage this disorder.

However, the never damage or degeneration can cause paraparesis. Keep reading this article to know the causes of paraparesis in detail.

Here are the main types of paraparesis divided according to their causes:

Hereditary spastic paraparesis (HSP)

Hereditary spastic paraparesis is an inherited neurological disease. Lower limbs stiffness can detect it. It causes the abnormality in long axons of the spinal cord. This condition occurs due to the X-chromosome deformity. Another name for this disorder includes Strumpell Lorrain or French settlement disease. This disorder mainly affects the primary motor neurons of the body. It may affect men and women.

Specific symptoms of Hereditary Spastic Paraparesis

• Improper speech
• Lower limb stiffness
• Muscles weakness
• Fatigue
• Toes stumbling
• Foot swallowing problem.

Causes of Hereditary Spastic Paraparesis

As this is a genetic disorder, the inheritance has more chance of developing this disease. The inheritance has three ways such as

• Autosomal dominant
• Autosomal recessive
• X-chromosomes connect to recessive diseases

Nearly 50 genotypes of 70 found affected by this condition. Approximately 30% of people don’t have a family history. In such case, this disorder randomly occurs as new genetic change. This disease doesn’t affect all children in the family, but their genes may get affected.

Tropical spastic Paraparesis

This disorder also identifies with the name of HTLV – associated myelopathy. This condition occurs due to the human t-lymphocytic virus. Commonly it is called as HTLV.

By this disease name we can understand, it mostly affects by the virus found in tropical regions and the Caribbean. This disease can occur due to nerve damage and severe trauma. The initial attack occurs in the spinal cord. Later, slowly this virus breeds and spread in the whole nervous system and cause damage. The people in the age group of 30 – 40 are more likely to get this virus attack.

There are two types of tropical spastic paraparesis

• Idiopathic tropical spastic paraparesis
• HTLV-I-associated myelopathy

Signs of Tropical spastic paraparesis

When someone gets these signs, the person should immediately consult a doctor.

• Urination problem
• Bowel movements Dysfunction
• Erectile dysfunction
• Severe back pain
• Legs movement inability.
• Abnormal skin problem with the red patch

In some cases, a patient with TSP gets some different signs such as;

• Eye’s uveal tract inflammation
• Swelling in lungs tissues
• Muscles-swelling
• Joints swelling
• Frequent dryness in the cornea

How this disease spread?

It may attack you normally. Apart from that it through a virus, this includes the following ways of disease spreading.

• Abnormal urine function
• Infectious blood transmission
• Breastfeeding (mother to child)
• Contaminated needle use to another person
• Contagious vaginal sex
• Other contagious sexual diseases

Mainly the Tropical spastic Paraparesis disorder affects the following organs in your body

• Spinal cord
• Limbs or hands
• Muscles
• TSP affect the urinary organs such as bladder, kidneys, and urethra.

Paraparesis Symptoms

Generally, no symptoms appear in the paraparesis disorder. Every cause of this disease shows a unique sign.

This disorder affects the walking ability and impairs the memory and vision function.

In hereditary spastic paraplegia, you may get the symptoms of muscle spasms in the legs which result in walking difficulties. Then it develops overactive reflexes. This condition loses the muscles sensation due to improper contract.

In paraparesis’s second type of tropical spastic paraparesis, weakness symptom occurs in legs. This weakness accompanies the loss of bladder and bowel control. This condition leads to erectile dysfunction in men.

This disorder shows the symptoms affecting motor functions of arm and hands. It may attack the sensation of nerves.

Let’s have a detail look over the symptoms.

Muscle Spasm

Muscle spasm is an uncontrolled contraction of muscles. It induces extreme pain to the patient. It happens when the side joints of the spine get inflamed and injured. It will result in spasm in spinal supporting muscles. This condition leads to normal back pain to complete loss of back muscles motion.

Muscle spasm is treated cautiously to prevent potential risk. You can manage the contraction with exercise therapy and muscle relaxants. It will help to reduce the tear and strain of muscles.

Memory Impairment

Memory Impairment is a symptom of paraparesis disorder. Memory impairment is a loss of memory recollecting ability. The affected person can find difficult to remember daily activities. This symptom may become acute and chronic.

In some cases, acute memory loss is naturally reversible. But chronic memory impairment leads to permanent brain damage.

Lower limb stiffness

The lower limb is a part of the lower body consists of hip and knee to ankle bones. The symptoms of paraparesis occur as lower leg stiffness. It happens due to muscles spasm and pain. The progressive stiffness may cause you musculoskeletal injury. Thus, the extreme stiffness reduces the ability of movement.

Bladder and Bowel dysfunction

During paraparesis, you may get the symptom of incontinence. Bladder and bowel dysfunction refers to the loss of controlling stool and urine. This condition makes you face the difficulty to handle the incontinence of urine and bowel.

In the functions of bladder and bowel, the nerves give the signal to muscles about when to tense up and relax.

To manage bladder control, nerves of the spinal cord send a signal to the brain.

Sphincter muscle holds the control to manage Urine flow

The anus and rectum muscles control and release the stool.

These all muscles process hold and release the urine and stool when you want.

When you get paraparesis disorder, your nerves get damage and send the wrong signal to the brain. This condition will result in incontinence. Discuss these issues with your doctor without hesitation. Your healthcare provider helps to manage the urgency problems.

Frequent dryness in the cornea

The cornea is a transparent layer of the front part of the eye. Insufficient moisture and lubrication cause the severe dryness in the eyes. The result of dry eyes can range from mild to constant eye irritation. It will result in inflammation and scarring of eyes front surface. This symptom may occur in Paraparesis.

Neurological Disorders

Neurological disorders are problem-related to the brain, and spine. There is 600 and more disorder of the nervous system such as

• Brain tumors
• Parkinson’s disease
• Stroke
• Epilepsy.

The neurological disorder is also a symptom of paraparesis. The neurological disorder can happen in any part the body’s nervous system. It can be a loss of memory, altered consciousness, loss of sensation and confusion.

When an individual has paraparesis due to injury may get neurological symptoms. The affected person may feel sensation or movement loss in legs. It happens because of the damaged nerves. The damaged nerves possibly disabled to send the signal to the brain. This condition makes the affected part unable to move.

Paraparesis Diagnosis

The diagnosis of paraparesis requires many tests based on its type. For example, a neurological evaluation by a Glasgow coma scale test will determine the level of brain function. This test will also show about restless leg syndrome.

MRI

It is a magnetic resonance imaging. It shows the detail of the spinal cord and its related nerves conditions. You may get the information about swelling in the spinal cord.

Lumbar puncture

This test can find the presence of an infective virus which has caused paraparesis. The HTLV-1 can identify with the evaluation of the Cerebral Spinal Fluid (CSF) received from the lumbar puncture.

Apart from the above test your doctor may analysis the following conditions.

• Mobility and motions symptoms in an affected person
• The family history of paraparesis disorder.
• Genetic movement disorder
• Vitamin b12 deficiency
• Structural spinal cord disease
• The sexual history of intravenous drugs usage in Tropical spastic paraparesis.

Treatment

The paraparesis is lifetime condition without any cure. Its treatment is intended to fight the symptoms of muscles spasms and pain.

Your doctor may prescribe the following medications.

• Anti-inflammatory drugs
• Muscle relaxers
• Pain relievers
• Corticosteroids
• Antispasmodic drug
• Antidepressants.

The symptoms of bowel and bladder incontinence are treatable with medication. You can also relieve the muscles spasm with physical therapy, speech and water therapy and motion exercises. Your doctor may suggest occupational therapy and electrical stimulation for muscles treatment.

To get the mobility benefits you can use a walker, shoe inserts, pelvic braces, cane, and wheelchair.

Follow other treatments for eating difficulties.

• Vitamin E
• Creatine
• Beta-carotene

Stretching Exercises

The regular stretch of muscles helps to maintain the flexibility and stable motion range. It is necessary to stretch your affected muscles gently and slowly. It will help to relive the muscles spasm. Stretching also helps to prevent tendonitis and bursitis.

• Start slowly stretching your muscles as much as possible.
• Hold this position for ten seconds and then return to normal.
• Do this exercise every day for a useful result.
• Do warm up before doing any exercise. If you are an aged person, then do it slowly with care.

Aerobic Exercises

After doing a good stretch get advice from an expert for proper aerobic exercise. Aerobic exercise helps to increase the oxygen. It improves heart and lungs muscle.

As you do aerobic exercise regularly, your energy levels improve. You will be able to control a healthy weight and get good sleep by preventing fatigue.

Do remember to warm up before and cool during exercise.

1. You can do walking; it is the best exercise for overall health.
2. You can do aqua exercises also. It is very gentle and provides amazing benefits. It prevents gravity effects and increases motion. Weak and tender muscles caused by paraparesis get relieved in warm water. If you choose deep water exercise, then use floatation device for body support.
3. You can do cycling in any weather. It helps to relieve knee and relieve region stress.

Strengthening Exercises

Doing strengthening exercises can improve muscles strength and mobility. These exercises increase your energy and boost your confidence level to gain physical power. Once you start regaining lost strength, your postures will get better. Your all pain reduces, and you can continue the daily activities efficiently.

Paraparesis can be a frightening diagnosis. It is a lifetime disease which can lower the mobility and create extreme pain. Whether the reason for this condition is gene deletion or infection, it develops and gets worse if you don’t care enough.

Medication and several physical therapies can identify the issue of paraparesis. It is necessary to increase and maintain your ability to move during disease. You can achieve the stretching by strengthening exercise and aerobic.

Conclusion:

People who have paraparesis may expect a normal life expectancy. People with HSP may not experience any symptoms. Paraparesis symptoms in the same family can occur at different times. In some cases, it may happen at the age of 50 years.

According to research, few genetic causes increase the symptoms severity. Most of the people can easily walk with some support. Some people may get benefit from cane, splints, and crutches. Very few individuals with paraparesis need a wheelchair to maintain mobility.