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December 1, 2011
Paralysis is a morbid condition at which loss of an opportunity to move or disturbance of motive function in a certain part of a body or several parts is characteristic. Paralysis is a symptom of a number of diseases of a nervous system. If the possibility of autokinesias nevertheless is lost not up to the end, then such state, is called paresis. This state is not a separate illness, therefore, its emergence does not provoke a certain single factor. Motive function will be able to be broken because of the most various damages of a nervous system. So, various injuries, infectious diseases, intoxications, frustration of a metabolism, defeat of vessels, disturbances in food, malignant tumors, and also factors hereditary or inborn can become organic origins of paralysis. Rather often paralysis is observed at syphilis, poliomyelitis, viral encephalitis, tuberculosis, meningitis. Can act as toxic origins of paralysis beriberi (B1 vitamin shortage), a pellagra (niacin shortage), organism poisoning with heavy metals. Disturbance of movements often takes place at inborn, hereditary, degenerative diseases of TsNS. So, the children's cerebral palsy often arises as an effect of a birth trauma. Disturbances of motive functions are shown also in a number of diseases of an unknown etiology. Paralysis is also shown as a result of psychogenic changes, in this case the help of the psychiatrist is effective.
In view of so wide range of the reasons for which paralysis is shown, pathomorphologic changes at this state have very different character and localization. So, at paralysis there is a degeneration, destruction, inflammatory processes, formation of the centers, a sclerosis, demyelination of nervous tissue. It is accepted to distinguish paralyzes as a result of defeat of the central nervous system and the paralyzes arising because of defeat of peripheral nerves. The first group of paralyzes, respectively, is divided into paralyzes cerebral (their origin — subcrustal, cortical, kapsulyarny, bulbar) and spinal (the reasons – diseases which provoke failure in functioning of the central and peripheral motor neurons). Defeats of textures, nervous roots, nerves, muscles are the reasons of flaccid paralyzes.
At defeat of the central and peripheral neurons there are different symptoms. Spastic paralysis — result of defeat of the central motor neurons, sluggish paralysis – a consequence of defeat of peripheral neurons. At psychogenic paralysis lines of either one, or other above described type of paralysis are shown. At the central paralysis touch and trophic frustration are shown, the tone of vessels changes. As a rule, there are problems of motive function in general. The muscles staying in the paralyzed state are strongly strained, however they will not atrophy. In extremities at paralysis tendon jerks remain or amplify, the fast spastic reductions called by clonuses are sometimes shown. Belly reflexes low or are absent in general. If the lower extremities are paralyzed, then a sign of injury of a brain is the Babinski's reflex of which the thumb dorsiflexion after intended irritation of the outer edge of a sole is characteristic. At a flaccid paralysis sensitivity is broken. The tone of muscles at the same time decreases, there is a damage of separate muscles which will atrophy and regenerate. In extremities which are paralyzed there are no deep reflexes or they very low, clonuses are not shown. There are belly reflexes, there is no Babinski's reflex.
Children's cerebral palsy
The children's cerebral palsy is a state of which disturbance of motive function is characteristic and which arises at the earliest age, sometimes in addition till the child's birth. As a rule, symptoms of cerebral spastic infantile paralysis arise at the child for his first year of life. Disturbances in work of motive system turn out to be consequence of disturbance of activity of a brain. At the same time disturbances of work of a brain can be various and remain throughout all life. Most often cases of a children's cerebral palsy are noted at newborns who have very low weight, and also at premature children.
Today a number of origins of cerebral spastic infantile paralysis is defined. So, the cerebral palsy can develop in the course of the course of pregnancy in the presence of morbid conditions at future mother. Premature births become risk factor, in the course of such childbirth possibility of bleeding in a brain which consequence the children's cerebral palsy can turn out to be increases. Premature babies often have certain trouble breathing that leads to insufficient receiving by an oxygen brain. Also sometimes cerebral spastic infantile paralysis to turn out to be consequence of such disturbance. At the same premature children brain activity quite often happens weak that is connected with pathologies in white matter of a brain. White matter is responsible for the correct signaling between a brain and other parts of a body.
Injuries of a brain, disturbance of genetic character, hematencephalon can provoke a children's cerebral palsy. As the general reason of cerebral spastic infantile paralysis the insufficient amount of oxygen in a brain is defined. If paralysis to turn out to be consequence of suffocation during the birth of the baby, then in that case there is a serious form of encephalopathy. Attacks, a condition of irritability, trouble breathing and food, a coma and a lethargy are characteristic of this state. Disturbances of activity of a brain can be shown also in process of difficult childbirth. Sometimes cerebral spastic infantile paralysis to turn out to be their consequence. However in several years of life of the child cerebral spastic infantile paralysis symptoms as result of difficult delivery, are practically not shown. Also cerebral palsy arises owing to the disturbances of work of a brain caused by ill treatment. However it is, as a rule, very difficult to establish the exact reason of display of this disease. The main diagnostic methods of cerebral spastic infantile paralysis are the computer tomography and research by a magnetic resonant tomography. Similar frustration do not progress, but exist throughout life.
Forms of a children's cerebral palsy
Among the most severe forms of this disease there is a double hemiplegia (tetraplegia). In the presence of such form of disorder of motive function are expressed both in upper, and in the lower extremities. It is very difficult for patient sit, stand and go they cannot. At this form of cerebral spastic infantile paralysis extremities and a trunk are deformed. Most of such children (about 90%) have the lowered intelligence, at 50-75% of children the secondary nanocephalia takes place. At this form of an illness the forecast of mastering skills of the movement adverse. Such children cannot socially adapt, learn to service themselves independently in life.
At the cerebral spastic infantile paralysis hyperkinetic form hyperkinesias, muscular dystonia are shown. Patients cannot correctly establish extremities, a body, to coordinate autokinesias. Such children learn to stand and go very late and only on condition of smaller damage of legs, than a trunk and hands. However they well control the head and reaction of balance. Motive frustration are accompanied by other problems — decrease in hearing, look paresis up, pseudobulbar frustration. At children the speech is violated. If disorders of motive function moderate, then patients on condition of existence of good intelligence can finish educational institutions.
At atonic - an astatic form of a disease of the patient it is not capable to hold a pose vertically. Patients learn to sit, stand, go, control the head very late. Try to sit only closer by two years, to stand and go — at the age of 4-8 flyings. At the same time about 90% of sick children with this form of cerebral spastic infantile paralysis have reduced intelligence which is combined with aggression, negativism, low emotionality.
At a hemiplegic shape of an extremity are surprised on the one hand, and, the hand is surprised more. After certain time installation of extremities and a trunk forms pathological. At such patient frustration painful, tactile, a thermoesthesia are observed. About 40% of children with this form of cerebral spastic infantile paralysis have different degree of a delay of mental development. Most of such patients can independently go therefore their social adaptation depends, first of all, on I.Q.
At an atactic form of an illness disturbance of balance and coordination is noted. Such children start walking approximately at three-year age. However when walking there is a dismetriya, an asynergia, a tremor, instability. The lowered muscle tone is noted. Delays of speech and mental development can be observed. Such children are trained in special establishments. Also often the mixed cerebral spastic infantile paralysis form which, as a rule, forms already in the senior age period meet.
Treatment of a children's cerebral palsy consists in continuous carrying out occupations by physiotherapy exercises, use of means which reduce a tone of muscles. Also the massage complex is applied. Also such patient appoints procedures which prevent progressing of rigidity in joints of the extremities affected with cerebral spastic infantile paralysis. It is ozokerite, paraffin applications. Administration of drugs which stimulate microcirculation is appointed sick and provide food of nervous tissue.
The decubitus paralitis is the phenomenon at which the patient realizes own inability to move. Such phenomena can arise when the person falls asleep or wakes up. Staying in a condition of a decubitus paralitis, the person loses ability to speak and move for several seconds or even minutes. Certain patients can feel asthma or pressure. The decubitus paralitis can be also shown as a symptom of other frustration of a dream. The similar paralysis arising during backfilling call gipnagogichesky or semiconscious, during awakening – gipnopompichesky. The decubitus paralitis is periodically shown at four of ten people, especially often decubitus paralitis is shown at teenagers. Such phenomenon can be hereditary. Besides the lack of a dream or change in its mode, stresses or other mental disorders, a dream of situation on spin, reception of some medicines and narcotic substances can provoke emergence of a decubitus paralitis.
If the person after awakening periodically finds out that he stays in a condition of the paralysis proceeding certain time, then it is a recurrent decubitus paralitis. As a rule, the similar state does not demand special treatment. However it is required to consult with the specialist if the similar state interrupts a sleep, or symptoms disturb the person very strongly, provoking a constant condition of fatigue.
In the course of inspection the specialist, first of all, is guided by detailed poll of the patient in detail to learn about frustration of a dream. For elimination of similar manifestations the doctor can recommend to improve dream habits, to receive medical treatment for antidepressants, to undertake treatment of mental disorders which provoke emergence of a decubitus paralitis.