Causes and differential diagnosis of acute flaccid paralysis. The key difference between flaccid and spastic paralysis is that in flaccid paralysis, muscles cannot contract and stay weak and floppy while, in spastic paralysis, muscles stay in contraction, and it is too rigid paralysis is a condition we associate with the loss of muscle function. However, these reports describe clinical and laboratory features that seem inconsistent with such diagnoses, and the exact cause of acute flaccid paralysis has not been thoroughly assessed with rigorous elec. Acute paraplegia weakness or paralysis in the legs is a particular emergency because. Key difference paraplegia quadriplegia vs hemiplegia different regions of the body get paralyzed in all conditions of paraplegia, quadriplegia, and hemiplegia. Severe or complete loss of motor function on one side of the bodythis condition is usually caused by brain diseases that are localized to the cerebral hemisphere opposite to the side of weakness. It is paralysis or weakness of both lowerlimbs due to bilateral pyramidal tract lesion, most commonly in the spinal cord spinal paraplegia, and less commonly in the brain stem or the cerebral parasagittal region cerebral paraplegia. Permanent flaccid paraplegia in children with thoracic. Difference between paraplegia quadriplegia and hemiplegia.
Paraplegia, sometimes called partial paralysis, is a form of paralysis in which function is substantially impeded from the waist down. Joining this list is epidemic acute flaccid myelitis afm, characterized by sudden denervationassociated muscle paralysis of healthy children. Furthermore, in flaccid paralysis, the muscle stays weak and floppy. The lower limbs are flaccid, and wasting of muscle groups eventually occurs. Paraplegia in children pdf this is a pdfonly article. Acute flaccid paralysis afp is a clinical syndrome which has many infectious and noninfectious causes. There is no treatment for polio, but many people are vaccinated. A 14yearold high school student is admitted to the pediatric neurology service because of the. On the other hand, spastic paralysis is a condition that gives rise to muscle stiffness. Flaccid paralysis can be treated using medicine, like antibiotics, if the cause is a bacterial infection. If paraplegia is present, mri or ct with myelography is appropriate to find the cause of paraplegia. Fortythree year old sri lankan female presented 2 weeks following traumatic head injury with bilateral flaccid complete paraplegia and urinary. What is cerebral paraplegia the lower limbs and bladder micturition centreare represented in paracentral lobule, leisions in this area produce paraplegia with bladder disturbanceeg retension urine and cortical type of sensory loss. Acute flaccid paralysis afp is a clinical syndrome char acterized by rapid onset of.
Flaccid paralysis is usually a sign of serious conditions like these. Paraplegia is the paralysis of lower extremities of the body because of an injury to. Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause e. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. Differential diagnosis of acute flaccid paralysis and its role in.
When both legs and arms are affected, the condition is called quadriplegia. Most commonly, paraplegia is the result of accidents, which occur most often in. Definitions of flaccid quadriplegia, synonyms, antonyms, derivatives of flaccid quadriplegia, analogical dictionary of flaccid quadriplegia english. Acute flaccid paralysis in infants and young children with enterovirus 71 infection. In cord compression damage may be due to mechanical stretching or ischemia. Rathore mf, gill za, malik aa, farooq f spinal cord 2008 apr. Facts and definition regarding paraplegia a paralysis of the lower half of the body including both leg, usually caused by damage to the spinal cord. This nervous system part includes two types of nerves central nervous system cns it includes brain and spina. It spares the upper limbs but, depending on the level, may involve the trunk, pelvic organs, or lower limbs. Enterovirus 71 ev71 infection is now considered an. Infectious diseases like guillainbarre syndrome and the bacteria in botulism can also cause the condition. Acute flaccid paralysis afp is a clinical syndrome characterized by rapid onset of weakness due to various conditions and the term flaccid indicates lack of corticospinal tract signs on. During 2014, we dealt with eleven cases of acute nontraumatic paraplegia, in our.
Fricke on difference between spastic and flaccid paralysis. Permanent flaccid paraplegia in children with thoracic spinal cord injury. Paraplegia is a term used to describe the inability to voluntarily move the lower parts of the body. Paraplegia, not to be confused with hereditary spastic paraplegia hsp, is an impairment in motor or sensory function of the lower extremities. There are numerous steps to recovering from paraplegiasteps that may change depending on the cause and severity of the condition. Zygomycosis may be the cause of epidural abscess and paraplegia usually in immunocompromised patients 62. The tendon reflexes are diminished or absent at the knee or ankle, and. Dr nor azni yahaya jabatan kesihatan negeri kelantan. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Most people with paraplegia have perfectly healthy legs. Improvement of the muscle capillary supply after earlystarted daily functional electric stimulation fes in human permanent lower motoneuron denervation roberto scelsi, paola poggi 1, ugo carraro 2, helmut kern 3 department of human pathology and 1 human anatomy, university of pavia. In a series from new york ungarsargon et al 1980 only 16 patients out of 672 admitted with a diagnosis of spastic paraplegia were recognized as having a familial disorder, although a few further cases may have had a genetic disorder and by chance have been isolated.
This syndrome in a child in fall 2014 was associated with enterovirus c105 infection. Difference between spastic and flaccid paralysis doctor. The presence of this virus strain in north america may pose a diagnostic challenge. It represents an initial manifestation of upper motor neuron lesions involving the central nervous system and spinal cord or a persistent manifestation of lower motor neuron lesions at the level of the. Most commonly, paraplegia is the result of accidents, which occur most often in the young adult male population, between 15. Infectious causes of acute flaccid paralysis request pdf.
Acute flaccid paralysis and west nile virus infection. Sarah bundey mb, frcp, in genetics and neurology, 1985. In people with spastic paralysis, they will often have involuntary movements of their legs or arms and it is very difficult to move the limb by another person like a physical therapy. The programme includes surveillance of acute flaccid paralysis afp to detect and diagnose. The areas of impaired mobility usually include the toes, feet, legs, and may or may not include the abdomen. A rapidly progressive cord lesion produces flaccid paralysis and absent reflexes and extensor plantar. Coincidence of guillainbarre syndrome presenting with landrys.
Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more. Multiple sclerosis paraplegia causes impairment in the motor or sensory functions of the lower limbs. Pain arising from the spinal site of metastasis is usually l5s1 arachnoiditis figure 10. Multiple sclerosis paraplegia also results in some or complete loss of sensation in the limbs. The overall prognosis of gbs is quite good, children with vital capacity approximately one half the normal value for age or. Treatment for paraplegia if an injury has been sustained that causes paraplegia, emergency medical treatment is needed to prevent further damage to the nervous system. While some people affected by this can walk to a small extent, most people are dependent on wheelchairs and other supportive measures. Acute flaccid paralysis in a patient with sacral dimple. Acute flaccid paraplegia is a clinical occurrence of extreme importance, due to the dramatic presentation, the severity of the underlying disorder, and the generally poor prognosis that follows such a condition. Mr imaging findings and clinical correlates chengyu chen, yingchao chang, chaoching huang, chunchung lui, kwowei lee, and songchei huang background and purpose. What is difference between spastic and flaccid paralysis.
A rare complication of meningococcal meningitis article pdf available in spinal cord 464. Paraplegia recovery can be a long and difficult process as paraplegics learn to cope with their paraplegia symptoms. Acute flaccid paralysis afp is a clinical syndrome characterized by rapid onset of weakness that involves the voluntary muscles and frequently includes respiratory and bulbar muscles. Flexor spasms were severe in both patients, but spasticity was absent. Difference between flaccid and spastic paralysis compare. Acute flaccid paralysis afp is a clinical syndrome characterized by rapid onset of weakness, including less frequently weakness of the muscles of respiration and swallowing, progressing to maximum severity within several days to weeks. Acute flaccid paralysis afp may be caused by a number of agents including enterovirus, echovirus or adenovirus. An outbreak of acute flaccid paralysis among children in the united states during summer 2014 was tentatively associated with enterovirus d68 infection. Hi, to understand spastic and flaccid paralysis, we must first understand motor nervous system. A 67yearold male known to be hypertensive and diabetic had a sudden onset of severe low back pain and flaccid paraplegia with no sensory level or bladder affection and the distal pulsations were felt. Support for children identified with acute flaccid paralysis under the. Acute flaccid paralysis in infants and young children with. From january 1960 to march 1979 25 children with spinal cord injury were admitted to our hospital 10 newborns with birth injury to the spinal cord were excluded.
Paraplegia and quadriplegia are caused by an injury or disease that damages the spinal cord, and consequently always affects both sides of the body. Causes of multiple sclerosis paraplegia dr garys multiple. Sacral dimple of more than 5 mm in diameter, lying 2. Aug 23, 2018 paraplegia has a host of causes, ranging from the local to the cerebral. It may result from many causes, of which the most common are.
Improvement of the muscle capillary supply after earlystarted daily functional electric stimulation fes in human permanent lower motoneuron denervation roberto scelsi, paola poggi 1, ugo carraro 2, helmut kern 3 department of human. It is paralysis or weakness of both lowerlimbs due to bilateral pyramidal tract lesion, most commonly in the spinal cord spinal paraplegia, and less commonly in the brain stem or the cerebral parasagittal region cerebral. Unfortunately, its not possible to combine the rise stimulator with one of our tricycles at this moment. Journal of acute disease 201516 1 contents lists available at sciencedirect journal of acute disease journal homepage. Definition sudden onset of weakness or paralysis over a period of 15 days in a patient aged less than 15 years age. Flaccid paralysis is directly caused by damage to nerves or cells. This damage can be caused by polio and by different kinds of viruses like the west nile virus. Severe or complete loss of motor function in all four limbs which may result from brain diseases. Flaccid paraplegia is a flaccid paralysis of two corresponding extremities, and is the antithesis of spastic paraplegia. This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. Inflammatory disease associated with spastic dysarthria. Lowermotorneuroneflaccid paraplegia this is characteristic of acute and chronic lesions of the cauda equina. Acute flaccid paralysis with sensory level necessitates a detailed examination of the back and magnetic resonance imaging spine.
A doctor will determine what therapies are needed to. Depending on the gravity of the disorder and the level of neuraxial injury, muscles of respiration. Permanent flaccid paraplegia in children with thoracic spinal. Paraplegia spastic flaccid paraplegia in extension paraplegia in flexion 4. Acute west nile infection and campylobacter have also been associated with afp. Acute compressive myelopathy was excluded by mri of the dorsal and lumbar spines. A person with a complete t12 level of injury is paralyzed from the waist down.
The nerve conduction study and csf analysis was suggestive of acute demyelinating polyneuropathy. A form for immediate notification of acute flaccid paralysis, form 1 37 a case investigation form for acute flaccid paralysis, form 2 28 a laboratory request reporting form for submission of stool specimen, form 3 40 a form for 60day followup examination of afp case, form 4 41 a form for final classification of afp case, form 5 41. Germany was used for coding, retrieving data, and merging of the researchers analysis. Acute aortic occlusion presenting as flaccid paraplegia. The term flaccid indicates the absence of spasticity.
The rise stimulator was designed specifically for this condition. Acute flaccid paraplegia free download as powerpoint presentation. Patients presenting with paraplegia resulting from metastatic tumours typically have a history of localised back pain in combination with a mainly flaccid type paraplegia developing over a short period, usually days or weeks. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit flaccid paralysis. Instead, the problem resides in either the brain or the spinal cord, which cannot send or receive signals to the lower body due to an injury or disease.
Causes and differential diagnosis of acute flaccid. Paraplegia may be hereditary or caused by birth injury, injury or disease of the brain or spinal cord or sometimes the peripheral nerves, as in alcoholic or dietary polyneuropathy, or by hysteria or old age. With a severe deformity, interpretation of these images. It is usually caused by spinal cord injury or a congenital condition that affects the neural brain elements of the spinal canal. Paraplegia is impairment in motor and or sensory functions of the lower extremities often including lower part of the trunk. A flaccid paraplegia is defined as a clinical syndrome, with rapid and symmetrical onset of weakness in both lower limbs, progressing to a maximum severity within several days to weeks1. What therapy can cause flaccid dysarthria and name some of the characteristics. Paraplegia article about paraplegia by the free dictionary. Although acute flaccid paralysis afp is more frequently seen in the tropics than in temperate regions, recent outbreaks of west nile virus wnv in north. Paraplegia is an impairment in motor or sensory function of the lower extremities. The main requirement is that the user cant feel a thing in his or her paralyzed muscles. Acute on chronic bilateral subdural hematoma presenting with acute. Paraplegia has a host of causes, ranging from the local to the cerebral. Pdf acute flaccid paralysis afp is a clinical syndrome characterized by rapid onset weakness, that many times includes respiratory and bulbar.
Pdf approach to a child with acute flaccid paralysis. Paraplegia definition of paraplegia by medical dictionary. Paralysis occurs mainly due to the failures in the nervous system. Difference between spastic and flaccid paralysis doctor answers. Jan 07, 2012 flaccid paralysis is a condition that gives rise to limp and floppy muscles that lack firmness. So, this is the key difference between flaccid and spastic paralysis. Acute flaccid paralysis associated with novel enterovirus.