Body movement is brought about by purposeful or involuntary contraction and subsequent relaxation of muscle fibers. If the function of individual nerves or the entire nervous system is disturbed in this process by disease or damage, the impulses to trigger muscle activity can no longer be transmitted properly. This can lead to a dysfunction of individual muscles, with the result that the affected extremities or body parts can no longer be moved or can only be moved to a limited extent. In these cases, the term muscle paralysis is used.
What is muscle paralysis?
The causes of paralysis are manifold. However, the main causes are nerve inflammation, muscle inflammation, infections and accidents. Basically, one can distinguish between voluntary and involuntary movements of the musculature. The movements are controlled by different levels of the central nervous system. Voluntary movements include, for example, the conscious and purposeful grasping of an object or the lifting of a foot to climb stairs. Involuntary movements, on the other hand, occur incidentally and automatically and ensure, for example, that balance is maintained during voluntary movements. If muscle activity is impaired as a result of damage, the result can range from slight and temporary paralysis of individual muscles to massive and permanent failure and paralysis of large parts of the musculoskeletal system. For example, sudden paralysis following mechanical damage (e.g., accident or herniated disc) may spontaneously resolve or be well treated with appropriate therapy. However, there are also chronic or congenital nerve and muscle diseases that cannot be cured and may lead to progressive paralysis (e.g., polyneuropathies or muscular dystrophies).
Causes
Muscle paralysis can be caused by a variety of factors.
- Mechanical damage: If an accident damages or even severs individual nerves or muscle fibers, paralysis may result. Also in the case of a herniated disc, there is a mechanical disorder, which can lead to impairments in the course of movement.
- Vascular disease: Minor cerebral infarcts or cerebral hemorrhages to strokes can cause larger areas of nerve cells in the brain to die. This can be manifested by sudden muscle weakness to temporary or permanent paralysis of one side of the face and body.
- Diseases of the central nervous system: multiple sclerosis (MS) or amyotrophic lateral sclerosis (ALS) are just two examples of such diseases. Both lead to progressive damage to nerve cells and permanent paralysis of increasingly large muscle areas.
- Bacterial and viral infections: With a simple tick bite, dangerous pathogens such as Borrelia can be transmitted and cause inflammation and paralysis in the nervous system. Furthermore, viruses can attack the nervous system and cause muscle paralysis such as polioviruses in polio.
- Cancers: Tumors in the brain, muscles, bones or spinal cord can mechanically or biochemically cause paralysis.
- Poisoning: Certain neurotoxins can also inhibit impulse transmission between nerves and muscles. These toxins occur in nature, for example, as batrachotoxin in the terrible poison dart frog or as botulinum toxin in spoiled canned food.
- Alcohol dependence:’ Prolonged high alcohol consumption can lead to toxin-induced damage to nerves and muscles and associated paralysis.
- Other causes: Psychological factors or migraines, for example, can also trigger paralysis symptoms.
Symptoms, complaints and signs
Muscle paralysis often occurs in the arms and legs (paresis), but can also affect individual skeletal muscles, for example, facial muscles, certain internal organs or vascular muscles. Signs of muscle paralysis can occur suddenly and without any apparent cause or insidiously, progressively or also in episodes. An incipient paralysis is often announced or accompanied by tingling, a feeling of numbness or perceptual disturbances in the affected parts of the body.
Complications
Depending on the type and severity of the paralysis, serious complications may arise that require secondary treatment. For example, paralysis in the lower extremities is often accompanied by a lack of bladder and bowel control in the affected person, which requires assistance. Perceptual disturbances in paralyzed extremities can cause injuries or infections to go unnoticed and worsen. Among the most serious complications that can occur due to paralysis are respiratory and swallowing reflex disorders, such as those that can occur in advanced ALS or even paraplegia. Affected individuals in such extreme cases can only be ventilated and fed externally.
When should one go to the doctor?
Mechanical injuries such as contusions, cuts, or sprains may cause temporary muscle paralysis. These should usually go away on their own as the injury subsides and do not make a doctor’s visit absolutely necessary. However, if in doubt, a doctor should always be consulted in the case of unclear paralysis symptoms. For example, spontaneously occurring muscle paralysis can be the first sign of a serious illness. Especially if there are other abnormalities in the cardiovascular system, speech or impaired consciousness, there is an urgent need for clarification by a physician. If the signs even point to a stroke, the emergency doctor must be notified in any case. Even if paralysis symptoms occur only temporarily, but repeatedly, consultation with a physician is recommended.
Diagnosis
To make a reliable diagnosis, affected individuals are usually first thoroughly questioned about symptoms, course, family history, and acute symptoms. This is followed by a physical and neurologic examination, during which the movement limitation that occurs is assessed. Often, an accompanying blood test is also performed. Depending on the findings, further imaging examination methods may be necessary, such as a computer tomography or magnetic resonance imaging of the affected area. Invasive examination methods such as a cerebrospinal fluid examination, muscle biopsy or special genetic tests may also be used for clarification. The results then lead to the diagnosis of muscle paralysis and its classification into variously severe forms of paresis (loss of strength or partial paralysis), plegia, or paralysis (complete paralysis).
Treatment and therapy
Analogous to the different causes of muscle paralysis, there are also many different treatments and therapeutic approaches. Depending on the type of paralysis, these are used in a targeted manner. Mild and only partial muscle paralyses with a mechanical cause often heal on their own. Depending on the severity, minor surgery may be necessary to restore the severed nerve and muscle connections. In cases of muscle weakness and paralysis due to a stroke, follow-up treatment with targeted physical therapy is provided to strengthen and invigorate the paralyzed half of the body. Any accompanying paralysis of the facial muscles often subsides on its own after several weeks. Bacterial or viral infections, on the other hand, are usually treated with a suitable antibiotic. In the case of Lyme disease, for example, a combination of active ingredients must be taken at fixed times over several weeks. The comparatively long duration of treatment is necessary because the bacteria only respond to the antibiotic effect of the medication during their division phases. If the treatment is stopped too early, a relapse may occur. In the case of tumors, surgery, radiation treatment or chemotherapy can lead to successful healing. The treatment of neurological diseases is much more difficult, since the paralysis is often progressive and irreversible. Here, often only the accompanying symptoms can be treated and a progression of the disease can be delayed as much as possible.
Outlook and prognosis
The prognosis and prospect of complete recovery must be viewed in a differentiated manner in muscle paralysis because of its many causes. Thus, a large proportion of paralyses may regress on their own, be successfully treated by appropriate therapy, or manifest permanently. The prerequisite for this is the timely consultation of a knowledgeable physician in case of doubt, who will prescribe the appropriate therapy in consultation with the affected person.Patients with muscle paralysis are either acutely or permanently in a difficult phase, as the quality of life can be more or less impaired depending on the extent of the movement restriction. In severe cases, muscle paralysis can lead, for example, to immobility or even permanent incapacity to work, which confronts patients with additional psychological difficulties that can also trigger secondary diseases such as depression or psychosomatic complaints. In individual cases, the prognosis can only be determined in discussion with the attending physician. Unfortunately, as the disease progresses, it often happens that the symptoms of paralysis or only the secondary diseases can only be alleviated symptomatically and a further worsening of the symptoms can only be slowed down. In severe manifestations, especially in neurologically induced paralysis, palliative medicine is often the only option left to alleviate the patient’s suffering and support his or her quality of life as far as possible in the context of a severely limited life expectancy.
Prevention
Especially in the case of cancer or neurological or psychological factors that favor muscle paralysis, prevention is difficult. What is generally advisable is a healthy lifestyle with sufficient exercise, alcohol and other stimulants in moderation, and a healthy diet. Preventive examinations offered by health insurance companies, which often include a blood test, should be taken advantage of. In this way, changes in the composition of blood or urine can often be diagnosed and treated at an early stage. In everyday life and during sports training, care should be taken to ensure that movements are carried out carefully and in a manner that prevents accidents, in order to avoid mechanical damage to the musculoskeletal system. A particularly high level of hygiene can be helpful against paralysis caused by bacterial infections. For example, frequent and thorough hand washing often prevents the spread of bacteria and viruses. To prevent infection with Borrelia, suitable protective clothing should be worn during stays in nature, especially in risk areas, and a tick check should generally be carried out afterwards.
Aftercare
In most cases of muscle paralysis, the patient has only very few and also very limited aftercare measures at his or her disposal. In this case, the affected person is primarily dependent on a quick and, above all, a very early diagnosis in order to alleviate and limit the symptoms. The earlier a doctor is consulted, the better the further course of the disease usually is. Affected persons should therefore ideally see a doctor at the first signs and symptoms. Most of those affected are dependent on various exercises and measures of physiotherapy or physiotherapy. These exercises can also be repeated in the patient’s own home in order to permanently alleviate the symptoms. In general, the affected person should avoid heavy physical exertion or stressful activities in order not to strain the body unnecessarily. Care and support from one’s own family is also very important in order to limit the symptoms and also to avoid psychological upsets. When taking medication, always ensure that the correct dosage is taken and that it is taken regularly. In case of ambiguity or side effects, a doctor should be consulted.
What you can do yourself
If in doubt or concerned, a doctor should always be consulted when muscle paralysis occurs. Although treatment may be lengthy in some cases, it is important to pursue therapy to increase the chance of successful treatment. In the event of a poor prognosis for progressive disease of a neurological nature, courage should not be lost. Although no cause-eliminating therapy is yet available for these paralysis symptoms, scientific research in these fields is constantly yielding new treatment methods and, above all, supportive measures that significantly improve the quality of life. For example, physiotherapy, massages and occupational therapy measures help to train the muscles, prevent pain and promote mobility in the affected areas.Participation in self-help groups or psychological counseling can also contribute to increased well-being and acceptance and acceptance of the changed situation among affected individuals.