Acute Paralysis (Acute Paresis)

Acute paresis – colloquially called acute paralysis – (ICD-10-GM R29.8: Other and unspecified symptoms affecting the nervous and musculoskeletal systems) is, in most cases, a neurological deficit symptom due to cerebral ischemia (reduced blood flow: approx. 80% of cases) or intracranial hemorrhage (bleeding within the skull; parenchymal, subarachnoid, sub- and epidural, and supra- and infratentorial hemorrhage)/intracerebral hemorrhage (ICB; cerebral hemorrhage); hemorrhage: approximately 20% of cases). The diagnosis is usually a transient ischemic attack (TIA), i.e., a sudden circulatory disturbance of the brain leading to neurologic disturbances that resolve within 24 hours, or an apoplexy (ischemic infarction or hemorrhagic infarction) and thus persistent neurologic disturbances.

The possible misdiagnoses are thus all differential diagnoses to transient ischemic attack and apoplexy (see there under “Differential Diagnoses”).

Frequency peak: TIA occurs predominantly in older age (> 60 years). Apoplexy occurs predominantly from middle age: After the age of 55, the risk of stroke doubles every 10 years!

Course and prognosis: An acute paresis is considered an emergency and therefore requires immediate inpatient clarification in a hospital with a “stroke unit” (special organizational unit within a hospital for the initial treatment of stroke patients). The course and prognosis of acute paresis depend on the underlying disease.