Paraplegia

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Paraplegia

  1. 1. PARAPLEGIA AN IMPAIRMENT IN MOTOR ORSENSORY FUNCTION OF THE LOWEREXTREMITIES.
  2. 2. • Both upper limbs + Both lower limbs QUADRIPLEGIA• Only one upper limb MONOPLEGIA
  3. 3. PARAPLEGIA• Spastic • Flaccid• Paraplegia in extension• Paraplegia in flexion
  4. 4. 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
  5. 5. CAUSES OF SPASTIC PARAPLEGIA (UMN type)• GRADUAL ONSET1. CEREBRAL CAUSES• Cerebral diplegia• Parasagittal meningioma
  6. 6. • SPINAL CAUSES1. Compressive2. Non compressive• Motor neuron disease• Multiple sclerosis• Frederich`s ataxia• Subacute combined degeneration
  7. 7. Compressive etiology• Intramedullary (5%)1. Glioma2. Ependymoma3. Chordoma
  8. 8. • Extramedullary• Intradural (15%)1. Meningioma2. Neurofibroma3. Patchy arachnoiditis (TB,Syphilis)
  9. 9. • Extradural (80%)1. Caries spine2. Myeloma,Lymphoma,Metastatic deposits in vertebra3. Patchy meningitis4. Prolapsed intervertebral disc
  10. 10. • SUDDEN ONSET• CEREBRAL CAUSES1. Thrombosis of unpaired anterior cerebral artery2. Superior sagittal sinus thrombosis
  11. 11. • SPINAL CAUSES1. Acute tranverse myelitis2. Injury to spinal cord3. Thrombosis of anterior spinal artery4. Haematomyelia5. Post vaccinal6. Prolapsed intervertebral disc
  12. 12. CAUSES OF FLACCID PARAPLEGIA (LMN type)• UMN lesion in shock stage• Sudden onset in neuronal shock,acute transverse myelitis,spinal injury
  13. 13. •LMN lesion involving anterior horn cells or peripheral nerves1. Acute anterior poliomyelitis2. Acute infective polyneuropathy3. Progressive muscular atrophy
  14. 14. • Diseases affecting posterior nerve roots• Tabes dorsalis• Diseases affecting myoneural junction1. Myasthenia gravis2. Periodic paralysis due to hypo or hyperkalemia
  15. 15. • Diseases affecting muscles• Myopathy• Hysterical paralysis
  16. 16. 5Ts• Trauma• Tumour• Tuberculosis• Thrombosis• Transverse myelitis

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