“Paralysis is defined as complete loss of strength in an affected limb or muscle group.”
The chain of nerve cells that runs from the brain through the spinal cord outdo the muscle is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscle cause periodic paralysis, in which the weakness comes and goes.
The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralysed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralysed muscle. Paralysis almost always causes a change in muscle tone. Paralysed muscle may be flaccid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved.
Paralysis may affect an individual muscle, but it usually affects an entire body region. The distribution of weakness is an important clue to the location of the nerve damage that is causing the paralysis.
The types of paralysis are classified by region:
- Monoplegia, affecting only one limb
- Diplegia, affecting the same body region on both sides of the body (both arms, for example, or both sides of the face)
- Hemiplegia, affecting one side of the body
- Paraplegia, affecting both legs and the trunk
- Quadriplegia, affecting all four limbs and the trunk.
The nerve damage that causes paralysis may be in the brain or spinal cord (the central nervous system) or it may be in the nerves outside the spinal cord (the peripheral nervous system).
The most common causes of damage to the brain are:
- Trauma (caused by a fall or a blow)
- Multiple sclerosis (a disease of that destroys the protective sheath that covers nerve cells)
- Cerebral palsy (a condition caused by a defect or injury to the brain that occurs at or shortly after birth)
- Metabolic disorder (a disorder that interferes with the body's ability to maintain itself).
Damage to the spinal cord or peripheral nerves is most often caused by trauma, such as a fall or a car crash.
INTRODUCTION TO STROKE
Imagine yourself in a marketing place and you suddenly collapse on the ground and are unconscious. It can be a STROKE!
To be classified as stroke, focal neurological deficits should persist for at least 24 hours.
Stroke is a disease that affects the blood vessels that supply blood to the brain. It occurs when a blood vessel that brings oxygen and nutrients to the brain either bursts or is clogged by a blood clot or some other mass. The former is called as the hemorrhagic stroke and the later an ischemic stroke.
When the rupture or blockage of the blood vessel takes place, there is no enough blood supply and hence, no enough nutrients and oxygen to that part of brain. This damages the nerve cells and may lead to their (cells) death.
As a result, that part of the brain is damaged which results in improper functioning of those body parts which are under the control of damaged brain area.
The term cerebrovascular accident (CVA) is also used to refer to the cerebrovascular conditions that accompany either ischemic or hemorrhagic lesions.
Stroke may be classified by the etiological categories, management categories and anatomical categories
Risk of STROKE:
- Age (over age 65)
- Brain tumor
- Coagulopathy (blood clotting disorder)
- High cholesterol level
- Heart disease
- Infection (e.g., meningitis, endocarditis)
Warning signs of STROKE?
- Sudden severe headache with no known cause
- Sudden difficulty seeing in one or both eyes (particularly in one eye)
- Sudden problems with walking, dizziness, loss of balance or coordination
- Sudden weakness or numbness of the face, arm, or leg on one side of the body
- Difficulty in swallowing
Care and Rehabilitation
Stroke rehabilitation is the process by which patients with disabling strokes undergo Occupational Therapy/ Physical Rehabilitation to help them return to normal life as much as possible by regaining and relearning the skills of everyday living. It also aims to help the survivor understand and adapt to difficulties, prevent secondary complications and educate family members to play a supporting role.
Stroke rehabilitation should be started as immediately as possible and can last anywhere from a few days to over a year. Most return of function is seen in the first few days and weeks, patients have been known to continue to improve for years, regaining and strengthening abilities like writing, walking, running, and talking. Daily rehabilitation exercises should continue to be part of the stroke patient's routine.