Pseudoparalysis characterizes paralysis that is not due to a disturbance in nerve conduction. There are several forms of pseudoparalysis. Their treatment depends on the specific cause.
What is pseudoparalysis?
Pseudoparalysis represents a collective term for paralysis that is not caused by changes in the conductivity of nerve cells. By definition, therefore, it is an apparent paralysis. The prefix “pseudo” comes from Greek and means deception. Thus, although pseudoparalysis is not true paralysis, it does appear with deceptively similar symptoms. By definition, paralysis means complete paralysis of motor nerves of individual body parts. Since nerve stimulus transmission from the brain to the corresponding body parts is interrupted, individual muscles or muscle groups there can no longer be stimulated. In contrast, incomplete paralysis of muscles is called paresis. Pseudoparalyses include conditions that resemble, among others, the appearance of progressive paralysis or other paralyses based on disturbances in nerve stimulus transmission. While progressive paralysis is caused by nerve damage in the context of syphilis, similar symptoms are observed in alcohol abuse (alcoholic pseudoparalysis) or arteriosclerosis. Furthermore, muscle paralysis can also occur after long periods of immobilization of the corresponding muscles or in muscle scars without impairment of nerve conduction. Pseudoparalyses are also known in vascular diseases and brain tumors. Furthermore, there is also Parrot pseudoparalysis.
Causes
There are many causes of pseudoparalysis. However, nerve damage is excluded in all of them. In that case, it would be a true paralysis. Thus, muscle tears, muscle weakness, long immobilization of corresponding muscles, rheumatic diseases, but also diseases of the brain, alcohol abuse or arteriosclerosis are possible causes. In the case of muscle diseases, the signals from the brain arrive at the muscle via the motor nerves. However, they cannot be converted into muscle contractions due to muscle damage or weakness. A typical example of this is the rotator cuff tear. In this injury, one or more tendons of the four shoulder muscles are torn. The arm hangs down because lateral lifting is no longer possible. Furthermore, the shoulder tendons may be calcified. The so-called tendinitis calcarea of the shoulder tendons also causes paralysis of the arms. The so-called parrot pseudoparalysis also causes the arm to hang down limply. Here, the cause is an epiphyseal detachment, which already develops in the unborn child of a mother suffering from syphilis. Acute pseudoparalysis can also occur with tendinitis calcarea in the hip joint. Tendinitis calcarea of the hip, similar to that of the shoulder tendons, may be infectious, traumatic, or neoplastic. In this case, the muscles of the rotator cuff are affected. In diseases of the brain, in alcohol abuse or arteriosclerosis, often insufficient signals are sent through the motor nerve conduits. This can also cause apparent paralysis along with other symptoms. Some pseudoparalyses may also be psychogenic.
Symptoms, complaints, and signs
Symptoms of pseudoparalyses are similar to those of true paralyses and depend on the particular cause. Paralysis of specific muscles or muscle groups occurs. For example, rotator¬cuff tears, Parrot’s pseudoparalysis, and calcific shoulder paralysis all involve paralysis in the shoulder muscles, resulting in flaccid drooping of the arms. The causes of all three conditions are different but do not involve nerve damage. The same is true for tendinitis calcarea in the hip joint, which is characterized by paralysis of the hip muscles and pain in the hip. As mentioned earlier, the counterpart of progressive paralysis is pseudoparalysis with almost the same symptoms. Progressive paralysis is caused by nerve damage in the context of syphilis. It leads to complete physical and mental deterioration. Predominant symptoms are progressive dementia or the development of psychosis. In addition, paralysis may occur.
Diagnosis and course of the disease
Paralyses and pseudoparalyses are symptoms of various diseases that require diagnostic clarification. The prerequisite is always a comprehensive medical history. Thereafter, imaging techniques and laboratory testing are used to specify the disease.
Complications
The complications and subsequent course of pseudoparalysis are highly dependent on the underlying disease. For this reason, a general prediction of complications is usually not possible. However, those affected suffer from paralysis in various parts of the body as a result of the disease. This can lead to restricted movement and other limitations in the patient’s everyday life. Most of those affected are then dependent on the help of other people in their daily lives. It is not uncommon for pain or tension to occur in the hip. This pain often spreads to the back, so that the affected person also suffers from pain there. If the pseudoparalysis is not treated, the physical and motor functions are reduced, so that it also comes to a mental retardation. In most cases, the symptoms of dementia or psychosis appear. Pseudoparalysis also has a very negative effect on fellow human beings, so that social discomfort and depression can occur. Pseudoparalysis is treated with the help of medication and various therapies. Complications rarely become apparent. However, a cure for pseudoparalysis cannot be guaranteed.
When should you see a doctor?
In the case of pseudoparalysis, a doctor should be consulted in any case. There is no self-healing in this disease and in most cases the symptoms worsen. The affected person must therefore always consult a doctor when the symptoms of pseudoparalysis occur. The doctor should be consulted when paralysis occurs in various muscles in the body. The paralyses may occur sporadically and need not be permanent. However, sporadic paralysis that occurs without a specific reason always indicates pseudoparalysis. The earlier the doctor is consulted in this case, the higher the probability of a positive course of the disease. In some cases, psychological complaints or mental deterioration may also indicate pseudoparalysis and should therefore be examined by a doctor. Friends or relatives may also recognize the symptoms of the disease and encourage the affected person to visit a doctor. The patient’s life expectancy may also be reduced by pseudoparalysis.
Treatment and therapy
Treatment of pseudoparalysis depends, of course, on the specific cause. For example, a rotator¬cuff tear is initially treated conservatively. If the pain is very severe, surgery is necessary, in which parts of the pectoral muscle are transferred to the shoulder. Conservative treatment includes the administration of non-steroidal anti-inflammatory drugs as well as analgesics. Glucocorticoids are injected under the acromion. Furthermore, physiotherapy with muscle building, manual therapies and various physical therapies are performed. Tendinosis calcarea of the shoulder or hip joint is also initially treated conservatively until the calcifications are dissolved. If this is not successful, various surgical therapies such as shock wave therapy, calcium aspiration or arthroscopy are available. For all other pseudoparalyses, the underlying disease must be treated. Their prognosis depends on the success of treatment of the underlying disease.
Prevention
A general recommendation for prevention from pseudoparalysis cannot be given because the causes of paralysis vary widely. It is also often only a symptom of an underlying disease. The risk of pseudoparalysis can, of course, be significantly reduced by preventing such diseases as diabetes or arteriosclerosis. Therefore, a healthy lifestyle with a balanced diet, plenty of exercise, and avoidance of alcohol and smoking is generally recommended.
Follow-up
Follow-up care is required if pseudoparalysis is caused by a rotator cuff tear in the shoulder and surgery is performed because of it. Follow-up care is then exceedingly important. Follow-up treatment is started as early as the first day after surgery.In this process, the patient receives effective pain therapy that is individually tailored to him or her. The primary goal is to prevent painful symptoms. In addition, special physiotherapeutic exercises are performed, which are also individually adapted to the patient. For this purpose, the physician first compiles a therapy plan. During the physiotherapeutic follow-up treatment, it is important, on the one hand, to immobilize the suture site to a large extent and, on the other hand, to avoid muscle atrophy. During the first ten days after the operation, the patient should take it easy on his arm. He is also given an abduction cushion at an angle of 45 degrees for a period of four to six weeks. At the same time, mobilization exercises are started under the guidance of a physiotherapist. Through these exercises, it is possible to improve tendon gliding and achieve greater resistance to tearing. In the further course, active exercises such as gliding exercises or pendulum exercises follow. After about six weeks, device-supported physiotherapy begins. Overall, the rehabilitation phase takes about three to six months. About 50 percent of all positive treatment successes are due to consistent follow-up treatment.
What you can do yourself
Once the doctor has made the diagnosis of pseudoparalysis, he or she will do everything necessary to find out the cause of this paralysis. After all, if the condition underlying pseudoparalysis is cured, the affected body part will usually be mobile again afterwards, provided the patient follows the doctor’s treatment instructions. This adherence to therapy – also called “compliance” – is extremely important, otherwise the cure of pseudoparalysis cannot be guaranteed. Depending on the underlying disease, several years of treatment with different therapeutic approaches as well as medications and/or surgery may be necessary. For many patients, pseudoparalysis is very distressing. It leads to a reduction in quality of life and also often means that the patient is dependent on others because, for example, they can no longer dress themselves or manage their daily lives on their own. This also puts a strain on the patient’s relatives and can cause social problems. This, in turn, causes the patient to become upset and even depressed. In this case, accompanying psychotherapy is advisable. Furthermore, the pseudoparalysis patient benefits from a healthy lifestyle in order to heal the underlying disease better and to prevent a new disease. Sufficient sleep and exercise in the fresh air are just as much a part of this as a balanced diet with fresh, healthy foods, plenty of fruit and vegetables.
