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Paraplegia
 

Paraplegia

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    Paraplegia Paraplegia Presentation Transcript

    • PARAPLEGIA AN IMPAIRMENT IN MOTOR ORSENSORY FUNCTION OF THE LOWEREXTREMITIES.
    • • Both upper limbs + Both lower limbs QUADRIPLEGIA• Only one upper limb MONOPLEGIA
    • PARAPLEGIA• Spastic • Flaccid• Paraplegia in extension• Paraplegia in flexion
    • Paraplegia in Paraplegia in flexionextensionLower limbs take an Lower limbs take an attitudeextensor attitude of flexionOnly pyramidal tracts are Both pyramidal &involved extrapyramidal tracts are involvedEvolution early Evolution late
    • CAUSES OF SPASTIC PARAPLEGIA (UMN type)• GRADUAL ONSET1. CEREBRAL CAUSES• Cerebral diplegia• Parasagittal meningioma
    • • SPINAL CAUSES1. Compressive2. Non compressive• Motor neuron disease• Multiple sclerosis• Frederich`s ataxia• Subacute combined degeneration
    • Compressive etiology• Intramedullary (5%)1. Glioma2. Ependymoma3. Chordoma
    • • Extramedullary• Intradural (15%)1. Meningioma2. Neurofibroma3. Patchy arachnoiditis (TB,Syphilis)
    • • Extradural (80%)1. Caries spine2. Myeloma,Lymphoma,Metastatic deposits in vertebra3. Patchy meningitis4. Prolapsed intervertebral disc
    • • SUDDEN ONSET• CEREBRAL CAUSES1. Thrombosis of unpaired anterior cerebral artery2. Superior sagittal sinus thrombosis
    • • SPINAL CAUSES1. Acute tranverse myelitis2. Injury to spinal cord3. Thrombosis of anterior spinal artery4. Haematomyelia5. Post vaccinal6. Prolapsed intervertebral disc
    • CAUSES OF FLACCID PARAPLEGIA (LMN type)• UMN lesion in shock stage• Sudden onset in neuronal shock,acute transverse myelitis,spinal injury
    • •LMN lesion involving anterior horn cells or peripheral nerves1. Acute anterior poliomyelitis2. Acute infective polyneuropathy3. Progressive muscular atrophy
    • • Diseases affecting posterior nerve roots• Tabes dorsalis• Diseases affecting myoneural junction1. Myasthenia gravis2. Periodic paralysis due to hypo or hyperkalemia
    • • Diseases affecting muscles• Myopathy• Hysterical paralysis
    • 5Ts• Trauma• Tumour• Tuberculosis• Thrombosis• Transverse myelitis