PARAPLEGIA

DEFINITION

PARAPLEGIA It is the paralysis of both the lower limbs. The term paraparesis indicates a condition of weakness of both the two lower limbs.

CAUSES

Due to general diseases of the nervous system

1. Motor neuron disease.

2. Syphilitic amyotrophy.

3. Subacute combined degeneration of the spinal cord.

4. Syringomyelia.

5. Peroneal muscular atrophy.

6. Peripheral neuritis.

7. Progressive spinal muscular atrophy in children.

8. Multiple sclerosis.

9. Myopathy.

10. Devic’s disease.

11. AIDS myelitis.

12. Tropical spastic Paraparesis (caused by HTLV-1)

13. Viral myelitis caused by VZV.

14. Non-metastatic manifestation of malignancy

15. Familial Paraparesis.

16. Hysteria.

Due to local causes affecting the spinal cord

1. Traumatic melopathy.

2. Myelopathy due to spondylosis and subluxation due to rheumatoid spondylosis (see afterwards).

3. Tuberculous myelopathy (Pott’s paraplegia) and other causes of compression myelitis, e.g. Caisson’s disease.

fluorosis, aneurysm of the aorta, etc. In tuberculous myelopathy vertebral bodies are destroyed and epidural abscess develops.

4. Myelitis due to post-infective encephalomyelitis, multiple sclerosis, subacute necrotising myelitis, poliomyelitis, neuromyelitis optica, syphilitic meningomyelitis.

5. Spinal epidural abscess.

6. Spinal epidural haemorrhage. This rarely develops after anticoagulant therapy or in bleeding diathesis.

7. Infarction of the spinal cord or myelomalacia and haemorrhage of the spinal cord or haematomyelia.

8. Spinal cord and other tumours, e.g., paravertebral tumours, extradural, intradural, extramedullary and intramedullary tumours, meningioma, neurofibroma.

9. Spinal arachnoiditis (meningitis serosa circumscripta).

10. Transverse myelitis.

11. Radiation myelopathy.

12. Toxic and metabolic myelopathy.

13. Lathyrism-This occurs after consumption of a pulse called lathyrus sativus (Khesari dal) containing a toxin B-(N) oxalylamino alanine.

14. Multiple myeloma.

15. Metastatic vertebral disease.

16. Paget’s disease.

17. Aneurysmal bone cyst.

18. Osteoporosis.

Cerebral lesions

1. Parasagittal tumour, e.g. menengioma.

2. Venous sinus thrombosis (Sagitlal sinus)

3. Hydrocephalus.

4. Multiple cerebral infarction.

5. Cerebral Diplegia.

6. Compression Paraplegia.

PARAPLEGIA

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