Paralysis is referred to when an individual experiences the inability to move some part of the body. This can be temporary or permanent, but regardless of severity, it can be experienced totally differently by one individual in comparison to another, and no doubt cause major emotional and physical upheaval.
Largely, paralysis is caused by damage to the nerves rather than by an actual injury, such as a back injury. For instance, an injury in the middle or lower regions of the spinal cord is likely to disrupt function below the injury, including the ability to move the feet or feel sensations, even though the actual structures are as healthy as ever.
It is sometimes easier to imagine the spinal cord as the brain’s relay system; its method of transmitting messages throughout the body. If the spinal cord is damaged through a spinal cord injury, it can cause a disruption of signals to areas of the body, and results in paralysis. Dr. Salvatore Insinga, chief of neurosurgery at Southside Hospital in New York explains spinal cord injury as ‘any trauma to the spinal cord that interrupts the flow of [electrical] information from the brain to wherever the nerves are going.’
Spinal cord injuries are often categorized initially into either complete or incomplete. Incomplete spinal cord injuries are the most common and with these, some signals can pass through the spinal cord leaving an individual with some level of movement which can be highly unpredictable. Complete spinal cord injuries are very different however, and these are often caused by accidents that completely cut or sever nerves in the spinal cord. This means no signals can travel in the spinal cord, and no movement will occur.
Different types of paralysis
With so many ways the spinal cord can be injured, there are many types of paralysis, and four main categories that concern different parts of the body affected.
Monoplegia
This type of paralysis occurs to a single part of the body, most often seen in a single limb, such as in the study by Dr. Pankowski, et al (2016) where a female patient experienced transient monoplegia in her right lower limb.
Much like in this instance, monoplegia can be temporary, especially in the aftermath of a stroke or brain injury where affected nerves avoided being totally severed. This regaining of function can be made possible through physical therapy.
So what causes monoplegic paralysis? There are various causes, including cerebral palsy, strokes, tumours, or brain injuries.
There is evidence to support the unusual instances where individuals have experienced transient monoplegic episodes from treated they have received, such as epidural blood patches, where they temporarily experience paralysis following treatments.
Hemiplegia
Much like monoplegia, cerebral palsy is the most common cause of hemiplegic paralysis, This kind of paralysis occurs from a brain injury, however this can be either congenital or acquired.
A patient who experiences this kind of paralysis affects an arm, a leg and face on the same side of the body, with varying severity. Many people experience some ‘stages’ in hemiplegia, starting with a prickly sensation, to some muscle weakening and then escalating to complete paralysis.
According to Krynauw, ‘the arm is always affected to a greater degree than the leg or the face’. He claims that despite the condition of paralysis of the arm, it is likely patients with hemiplegia will learn to walk again. Again, similarly to monoplegia, the severity of this kind of paralysis can vary from day to day, and depends upon many lifestyle factors.
There are many informative websites that offer support and guidance about hemiplegia, including HemiHelp, which concentrates on this kind of paralysis in children and young people. Their goal is to inform children about their lifelong condition and build support networks for their adulthood.
Motivational speaker Irene Fischer experienced hemiplegia in 2009 following a traumatic brain injury, and she is charmingly honest about her experiences of the condition.
Hemiplegia can be confused with hemiparesis, which is in fact a precursor to hemiplegia. This condition refers to the weakness felt on one side of the body. Although totally different conditions, it is paramount if you feel weakness in one side of your body that you seek medical help immediately.
Paraplegia
This form of paralysis affects the body below the waist, affecting legs, hips and functions including sexuality and the excretion. How people experience this kind of paralysis can differ from patient to patient, and although paraplegia generally denotes the loss of use and feeling below the waist, this can be changeable depending upon the individual.
It is uncommon for anybody to recover from this, although intensive physical therapy and functioning can help strengthen muscles and nerve connections. Paraplegic paralysis is most often caused by spinal cord injuries, and these affect the brain’s ability to send and receive signals from below the site of the injury. Dr. Curtis, et al say there are an estimated 265,000 individuals with SCI in the United States, and ‘approximately … 47% have lesions below the first thoracic level (paraplegia)’.
The blog How iRoll is a great source of information and support for anybody newly paralyzed. Concentrating on life in a wheelchair, it is a funny and honest place where people can be frank about their stories, share experiences and support one another through tougher times and learn to adapt to life as a paraplegic.
Quadriplegia
Sometimes referred to as tetraplegia, this form of paralysis happens below the neck. Most commonly, all limbs and torso are affected, and much like other types of paralysis, the loss of function can vary from one individual to another.
Quadriplegia can occasionally be a temporary condition following brain injuries or strokes, and some spontaneously regain some functioning during their recovery. Most, however, must retrain their bodies through dedicated and intense physical therapy. Much like paraplegia, the leading cause of this kind of paralysis is spinal cord injuries through sporting accidents like football, vehicular accidents and aggressive assaults such as the ones Dr. Frederick M. Maynard, et al surveyed in his study on prognosis after traumatic quadriplegia, including gunshot and stab wounds.
Paralysis can happen in countless ways, and every person’s body will react and respond in a slightly different way, hence we need a few categories for the types of paralysis to sit in. By having these different forms, individuals can get the right kind of person-centered care, and they can educate themselves on their condition, treatment, and prognosis.
