Definition
A paraplegic syndrome or paraplegia (med. paraplegia, transverse syndrome) is understood to be damage to the spinal cord and the resulting symptoms. A distinction is made between a complete paraplegic syndrome, in which the spinal cord is completely severed, and an incomplete paraplegic syndrome, in which the spinal cord is only partially damaged. The symptoms of paraplegia depend on the extent of the damage to the spinal cord.
The possible causes
The spinal cord runs inside the spine and together with the brain forms the central nervous system (CNS). The spinal cord consists of nerve tracts that serve to transmit motor and sensitive information between the brain and the muscles, skin and internal organs. Motor pathways are used to move the muscles, whereas sensitive nerve pathways enable the perception of sensations such as pain, temperature sensation and touch.
The causes of a paraplegic syndrome are in most cases (about 70%) injuries to the spinal cord caused by accidents, e.g. after motorcycle or car accidents. Blunt force from outside can lead to vertebral fractures and crushing or compression of the spinal cord. Other causes of paraplegia are circulatory disorders in the area of the spinal cord, inflammation, herniated discs, infections or tumors.
A stroke in the spinal cord results in a lack of oxygen (med. spinal ischemia), i.e. due to an occlusion in the blood vessels, the spinal cord can no longer be adequately supplied and is damaged. In the case of a severe herniated disc, it is possible that the leaked disc nucleus pinches the spinal cord or nerve roots and thus damages them. Often the cause of a cross-sectional syndrome is also tumors that either originate directly from nerve tissue in the spinal cord or metastasize from other organs into the spinal column. The space requirement leads to compression and injury of the spinal cord.
The forms of the paraplegic syndrome
In incomplete paraplegia, the spinal cord is not completely severed or damaged. As a result, the function of individual spinal cord tracts remains intact and allows at least partial stimulus transmission. The symptomatology depends on the height of the lesion.
However, the residual motor and sensory functions remain intact even below the damage. Incomplete paraplegia can affect either the arms or legs (med. paraparesis) or all extremities (med.
tetraparesis). Compression of the spinal cord due to trauma, tumors or herniated discs are the main causes of incomplete paraplegia. Paralysis of the leg?in a complete paraplegic syndrome, the entire cross-section of the spinal cord is damaged, destroying all nerves.
Immediately after the traumatic damage, a spinal shock occurs. This is a temporary condition in which all motor and neurological functions below the lesion fail completely. The extremities are flaccidly paralyzed.
After a few weeks, the flaccid paralysis changes into spastic paralysis, in which the tension of the muscles is pathologically increased and the muscles become permanently tense. In addition, the complete paraplegic syndrome leads to a loss of sensitivity below the height of the lesion and to the appearance of pathological reflexes (e.g. Babinski reflex), i.e. reflexes that do not occur in healthy people. Furthermore, bladder and bowel emptying disorders can occur.
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