What is Paraparesis?
Paraparesis is a medical condition that is characterized by the weakness or paralysis (partial) of the lower extremities. This condition has no cure; instead management is given away to patients with this condition. There are two forms of paraparesis and these are:
Types of Paraparesis
Hereditary spastic paraplegia
This is also known as familial spastic paraparesis that is genetic in nature. There is progressive nerve degeneration. Tendency of this condition is that a parent may pass the disorder to their children.
Tropical spastic paraparesis
This condition is basically caused by HTLV or human t-lymphocytic virus. The direct affectation is the spinal cord which would eventually cause for nerve damage. It has been noted that this condition can be permanent or life-long and even become progressive. This condition is mostly found in women, beating the men in a 3:1 ratio. Those who are less fortunate are most affected of the spinal cord infection.
Diagnosis
In order to identify the presence of the condition, one shall undergo these series of tests:
Neurological examination
This would include the client’s RLS and GCS.
MRI
This can visualize the spinal cord and can rule out other possible conditions. Spinal cord swelling can be noted if one is suffering from paraparesis.
Lumbar puncture
This can identify for presence of the infective agent that may have caused the condition. Identification of the HTLV-1 is possible with the analysis of the CSF obtained from the lumbar puncture.
Paraparesis Symptoms
According to the type of paraparesis, here are the following manifestations of the disease condition:
Tropical spastic paraparesis
- Would start as asymptomatic
- The gradual onset of the symptoms begin, such as leg weakness
- Urinary incontinence
- Bowel dysfunction
- Referred back from the legs
- Erectile dysfunction in men
- Affectation of the upper extremities may also be prominent. Sensation may also be altered.
Hereditary spastic paraparesis
- Spastic leg paraparesis
- Changes in gait or there would be difficulty attaining usual gait
- Hyperreflexia
- Clonus
- Sensation is altered
- Neurological affectation: optic atrophy, dementia, intellectual disability
Paraparesis Causes
The root cause for paraparesis is nerve damage or by trauma. Acquiring infections are deeply causal and eventually will affect the spinal cord. According to type, here are the causes of paraparesis:
Tropical spastic paraparesis
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The said condition was initially known to be affecting those who live in tropical countries, but today it has been noted that the condition also affects those who live in temperate regions. The agents HAM/TSP are the ones that affect the spinal cord, greatly affecting the lower extremities. There would also be possible leading of gradual paralysis when the degeneration worsens.
Hereditary spastic paraparesis
The condition is related to genetics and is associated with neurological abnormalities. The condition is said to be autosomal dominant or X-linked.
Paraparesis Treatment
Treatment for paraparesis would vary from the type of condition:
Tropical spastic paraparesis
This would include taking of oral methylprednisone, interferon alfa and antiretroviral agents. These can help in the fighting off the viral agent responsible for the disease process. Pentoxifylline is a drug that is yet being tested for effectivity in treating paraparesis.
Hereditary spastic paraparesis
This would include taking of Baclofen orally, a drug used for spasticity. This is a muscle relaxant and can reduce the stiffness or spasticity of the muscles. Diazepam, clonazepam, dantrolene and tizanidine are also prescribed by the doctors. Anxiolytics are recommended for they can result to muscle relaxation.
In general, this condition should be treated with physical therapy. This is essential in maintaining the ability of the client to work and do activities of daily living. Physical therapy can also help in the improvement of the person’s strength. With the physical activities, we can also avoid muscle atrophy because of not using them properly and as regularly as it should be. Here are the recommended exercises:
Strength exercise
This can help strengthen ones muscles and avoid them from becoming weak. This can also help in avoiding dysfunction of the muscles. Avoidance of atrophy or decreased muscle tone can be attained.
Stretching exercise
This can increase a patient’s range of motion and avoid muscle difficulties such as cramps.
Aerobic exercises
This can help improve a clients’ body fitness and increase his or her endurance. There are various forms of aerobic exercise and these include walking, swimming and even riding the bicycle.
