Paraparesis is a neurological disorder that causes partial paralysis of the limbs. There will be mild to severe weakness or paralysis on the hands or limbs. This disorder cannot be cured but it can be managed by therapy. There are several factors which causes this disorder. Usually it cannot be cured however the symptoms can be managed.
Types :
Two types of paraparesis are recognized.
Hereditary spastic paraplegia is the first type which is genetic in nature. The parent will have some numbness or weakness in the extreme muscles and the nerve degenerates slowly and causes paralysis to the offspring. Parents with this kind of weakness or tingling sensation have greater chances to pass it on the disorder to their children than healthy individuals.
The second type of paraparesis is tropical spastic paraplegia. It is caused by virus infection on the spinal cord. Human T lymphotropic virus slowly causes nerve infection which would then gradually damages the nerve functions. The first sign of symptoms will appear when the individual enters into the adulthood (30-40 years). The symptoms originate commonly after one has travelled to tropical region.
Causes :
As mentioned above, this disorder can be caused by genetic causes or by virus infection on the spinal cord. People can get his disorder due to nerve injury during accident. The infection may worsen as time progresses causing more and more weakness of the limbs and hands, restricting the people to be on wheelchairs. After identifying the initial signs one should consult a physiotherapist to learn how to cope up with this disorder.
Symptoms :
Initially the disease will not show any symptoms. After the spread of infection it would begin as weakness in legs or in the form of Urinary Incontinence. In men it may cause erectile dysfunction and some people may lose sense in the extremities due to intense nerve damage.
In severe cases, there may be considerable changes in gait and it becomes difficult to attain normal method of walking. For some people there can be frequent bowel movement. It can cause paralysis on the legs and hands making him unable to use them. Hyperflexia is also seen on some people. In rare cases, it may affect optical nerves causing vision problem and Dementia (loss of memory).
Diagnoses :
Your doctor may look out for the above symptoms of weakness of limbs, tingling sensation and numbness on hands. He would do MRI scan or a lumbar puncture test to identify the HLTV virus and swelling of spinal cord.
Treatment :
Treatment varies with the intensity of damage caused to the nerves and the age of the patient. Since there is no medical cure for this problem, the patient will have to learn to manage with this disorder successfully. Physical therapy is given for regaining muscle strength. Medications like corticosteroids and anti-inflammatory drugs are given to reduce swelling of nerves in spinal cord. Often the treatment is to be continued for the entire life to avoid any complications.
Some doctors prescribe interferon alpha therapy for quick relief of symptoms and also interferon beta method. Lioresal is prescribed for patients with stiff muscles.
For treating bowel and urinary incontinence oxybutynin is given. Baclofen injection is given for reducing spasticity and relaxing stiffness of muscles. For controlling pain diazepam and clonazepam are given in proper dosage.
Regular physiotherapy is given to manage daily activities and to reduce muscle rigidity. Stretching exercises, strengthening exercises are practiced daily for managing muscle difficulties and for increasing range of movements. Further aerobic exercises are to be done for keeping fit and enhancing endurance.
