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Paresis – decreased muscle strength.

This condition is a consequence of various diseases and does not depend on belonging to a particular gender, so we can say that it occurs with equal frequency among both women and men. The age range is also different and depends on the cause of paresis. A decrease in muscle strength leads to a decrease in working capacity and the inability to cope independently in everyday life, therefore the development of paresis is a serious social problem and requires timely provision of medical care.

Based on the area of ​​the body in which paresis occurs, it is customary to distinguish the following types:

• monoparesis – symptoms appear on only one arm or leg;
• paraparesis – signs of paresis are present on both parts of the body, which are located symmetrically in relation to each other. With paresis of the arms it is called upper, with paresis of the legs - lower;
• hemiparesis – paresis affects one half of the body;
• tetraparesis - all limbs are affected.

Depending on the level of damage to the nervous system, there are two types of paresis:

1. Central (damage is localized at the level of the brain and spinal cord);
2. Peripheral (peripheral nerves are damaged).

The main causes of central paresis:

• stroke;
• traumatic brain injuries;
• spinal cord injuries;
• tumors of the brain and spinal cord;
• intervertebral hernia;
• multiple sclerosis;
• amyotrophic lateral sclerosis (ALS);
• cerebral palsy.

Among the causes of peripheral paresis are the following:

• radiculitis;
• demyelinating diseases of the nervous system;
• peripheral nerve injuries;
• compression of nerves, so-called “tunnel syndromes”;
• nerve damage due to connective tissue diseases and vasculitis;
• various poisonings, including alcohol.

Symptoms

With central paresis, there is a decrease in muscle strength, which has varying degrees of severity. Some people experience rapid fatigue, which occurs after intense physical activity. In this case, a person notices the appearance of fatigue after a hard day of work or sports. There is another variant of the manifestation of central paresis, when there is an almost complete loss of movement. In this case, the quality of life is significantly reduced; even performing any actions in everyday life is difficult for a person or requires outside help. There is also an increase in the tone of the affected muscles, normal reflexes intensify and pathological ones appear, which should not normally be present in a person. Due to increased muscle tone and limited physical activity, contractures occur. This means that there is a restriction of movement in the joint, as a result of which the limb cannot be fully flexed or straightened at the site of contracture.

Peripheral paresis occurs when the nerve is directly damaged. In this case, the disorder develops in one group of muscles that are innervated by the damaged nerve. Therefore, muscle weakness often manifests itself in the form of monoparesis, that is, it affects one leg or arm. Unlike central paresis, with peripheral paresis there is a decrease in muscle tone, weakening of reflexes, involuntary muscle twitching appears, and muscle atrophy develops.

Diagnostics

Diagnosis begins with interviewing the patient. The localization of the onset of weakness and possible previous causes contributing to the appearance of paresis are clarified. It is important to find out whether there are people in the family with similar symptoms, and also to clarify the place of work, namely the presence of occupational hazards. After the conversation, the doctor proceeds to a neurological examination, during which muscle strength is assessed on a 5-point scale:

• 5 points – no paresis, muscle strength is completely preserved;
• 4 points – mild paresis;
• 3 points – moderate paresis;
• 2 points – severe paresis;
• 1 point – pronounced paresis;
• 0 points – paralysis.

A neurological examination is aimed at differential diagnosis between central and peripheral paresis. To do this, the volume of active and passive movements, reflexes, muscle tone are checked, atrophies, fascicular and fibrillary twitches are identified. After a general examination, laboratory and instrumental research methods are prescribed. To detect signs of poisoning, a toxicological blood test is prescribed. A general blood test can reveal signs of inflammation, and an increase in the level of leukocytes and ESR will be observed.

ENMG (electroneuromyography) has good information content. This research method allows you to evaluate the electrical activity of muscles, the speed of nerve impulses along the motor and sensory fibers of peripheral nerves, and the number of functioning motor units. EEG (electroencephalography) allows you to evaluate the electrical activity of different parts of the brain. This is important, since this indicator changes with various diseases of the central nervous system. CT and MRI of the spinal cord and brain help in visualizing various pathological conditions, such as tumors, hemorrhages and the like. MRA (magnetic resonance angiography), as the most accurate and safe method for studying cerebral vessels, allows not only to see the blood vessels of the brain and study their anatomical features, but also makes it possible to identify functional defects at a fairly early stage.

Treatment

For successful treatment, it is necessary to first establish the cause that caused the development of paresis. If a tumor or hematoma is detected, surgical treatment is required. In the case of an infectious lesion of the brain or spinal cord, antibacterial drugs are prescribed, which are selected taking into account the sensitivity of the microorganism that is causing the infection. Medicines that help improve cerebral circulation and metabolism are also used. In addition, drugs are prescribed to improve nerve conduction, since it is nerve impulses that generate the work of muscle tissue.

For preventive purposes, it is recommended to lead a healthy lifestyle, namely, give up bad habits (smoking, drinking alcohol), develop a balanced diet, do not forget about dosed physical activity, maintain a day and night routine (sleep should be approximately 7.5 hours daily) . It is important to monitor blood pressure levels, do not forget to take medications that help lower blood pressure, and promptly treat infectious diseases. If appropriate symptoms appear, you should immediately consult a doctor and never delay visiting a specialist, since early initiation of treatment helps improve the prognosis of the disease.

Medicines

In the treatment of paresis, neuroprotectors are used - drugs that help protect nerve fibers. For this purpose, B vitamins (B1, B6, B12) are prescribed, which are either used individually or in combination. An example of such a combination drug is Milgamma. This drug is able to restore metabolism inside cells, which helps slow down the process of destruction of myelin (the sheath of the nerve fiber), and also affects myelin regeneration. It is recommended to prescribe in 2 stages. At the first stage, an injection form of the drug is used, at the second, a transition to tablets is made.

Vinpocetine is used to improve cerebral circulation. Its effect is achieved by dilating cerebral vessels. In addition, the drug has antiplatelet and antihypoxic effects. Some experts consider this drug to be outdated and ineffective, but, nevertheless, it is still used to this day.

For neuroinfection, antibiotics are used if there is a bacterial etiology of the disease. The choice of antibacterial drug is made based on an analysis of the sensitivity of the microorganism that causes the infection to certain groups of antibiotics. Often, treatment begins before the test results are obtained, and broad-spectrum antibiotics are used. For example, cephalosporins may be prescribed.

It is important to understand that a phenomenon such as paresis can be a manifestation of various diseases, therefore the treatment is carried out by a qualified doctor who is able to select the necessary treatment taking into account each individual case.

Folk remedies

Paresis does not mean a complete loss of motor activity, so it is important to engage in therapeutic exercises and physical education for a long time, gradually increasing the load. The course of therapeutic exercises is selected by the attending physician and carried out in a medical institution. This is necessary so that each time the patient is under the supervision of a specially trained person who can assess the correctness of the exercise technique, as well as monitor the dynamics of treatment. In addition, it is important to exercise yourself and at home in order to improve and speed up the expected effect of treatment. A gradual increase in load should subsequently be complemented by movements with resistance. This will help in increasing muscle size and strength.

Therapeutic exercises should be combined with massage sessions, which improves tissue nutrition, promotes the formation of nerve impulses, and also prevents the development of muscle atrophy. You can sign up for a massage with a specialist, but given that this therapy is long-term, it is possible to teach massage techniques to relatives so that they can constantly practice at home.

For peripheral paresis, physiotherapeutic procedures have a good effect. They help improve blood circulation, stimulate metabolic processes and trophism, and help restore lost function. In this case, physiotherapy is used:

• diadynamic currents;
• electrophoresis;
• magnetotherapy.

Currently, acupuncture (acupuncture) is gaining momentum. This is one of the methods of alternative medicine, which still has a lot of critical views from various specialists, however, despite this, the demand for this procedure is progressively growing.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

Paresis of the limbs is a disorder that is expressed. The disease develops as a result of the secondary manifestation in a group of any disease or condition that is caused by a dysfunction of the brain system.

Paresis is characterized as a special case of a disease such as paralysis, which arose as a result of limitation of normal motor functions due to the innervation of a particular muscular system.

A distinctive feature of paresis from other motor function disorders is that it affects the central and peripheral nervous systems. As a result, there is a loss of motor activity.

The main causes of paresis are considered to be damage to the human nervous system pathways that are responsible for performing movements of the limbs (motor nodes of the spinal cord and brain, nerve fibers of the peripheral and central systems).

Forms of limb paresis

The main forms of paresis of the limbs can be presented in the following table, which characterizes the causes, origin, and distribution of this phenomenon.

Main symptoms and causes of paresis

With a neurological syndrome such as paresis, muscle weakness or further human symptoms are closely associated with the following manifestations:

• Deviations in gait (weakness in the muscles of the pelvis and legs);
• Foot drop when lifting the leg (weakness of the extensor muscles of the leg);
• Difficulty when trying to get up from a sitting position, as well as difficulty moving your legs;
• Difficulty in performing manual actions (lifting, holding).

Based on research in medical science, as well as practical activities, the following causes of paresis of the limbs have been established:

1. Disorders and hemorrhages in the spinal cord and brain (stroke).
2. Different spinal cord and brain.
3. Injuries occurring in the head and spinal region.
4. Inflammatory diseases of the cranial system (myelitis, encephalitis).
5. Diseases associated with disturbances in the conduction of signals in nerves, which cause damage to the myelin layer of neurons in the central or peripheral nervous system.
6. Purulent processes in the brain (abscess).
7. Poisoning caused by nerve agent and industrial poisons.
8. Diseases of immune-inflammatory origin, which are expressed by the absence of reflexes,
9. Botulism is a serious infectious disease that occurs when the nervous system is damaged. Occurs due to food poisoning containing botulinum toxin.
10. Myopathy is one of the types of disease in which metabolism in muscle tissue is disrupted.
11. Epilepsy is a disease caused by an epileptogenic source in the brain.
12. Motor neuron diseases (amyotrophic sclerosis, back muscle atrophy).

How is paresis diagnosed?

In order to identify a disease such as paresis, a whole range of measures is carried out, the purpose of which is to determine the causes of this phenomenon.

As a rule, a set of the following activities is carried out:

• Examination and consultation with a neurologist. The situation is analyzed and symptoms are searched, and the loss of muscle strength is assessed;
• Prescribing blood tests (toxicological analysis, general, biochemical).
• Electroneuromyography (ENMG). This method makes it possible to assess the electrical activity of muscles and the speed of transmission of nerve impulses.
• Electroencephalogram (EEG). This method assesses the activity of areas of the brain.
• and CT.
• Magnetic resonance angiography (MRA). A method in which brain tumors are detected, as well as the possible integrity and patency of the arteries in the cranial region.

Treatment of paresis

Paresis of the limbs can be characterized as a secondary disease that occurs due to the manifestation of the underlying disease. Therefore, the direction of treatment should be aimed at combating the disease that caused the paresis.

In the event that a decrease in muscle strength is caused by injuries to the limbs, it is possible. When carried out, nerve conduction is restored.

In cases where the cause of paresis is a cerebral hemorrhage, it is necessary to use drugs that increase the processes that cause blood circulation in the brain.

Paresis (from the Greek “paresis” - weakening) is a movement disorder associated with a weakening of voluntary movements.

The causes of this disorder are various types of damage in the motor systems of the brain.

It can be either congenital or acquired as a result of exposure to unfavorable factors on the body in the form of injuries and neuralgic disorders.

The disease is divided into several types depending on what part of the body the paresis is localized in (mono, and). This article will discuss such a subtype of movement disorders as monoparesis.

Features of movement disorders

Monoparesis is a pathology in which the motor capabilities of one limb, arm or leg are impaired.

Paralysis of this kind is most often of a central nature.

In frequent cases, such disorders are accompanied by a disease called , which is characterized by lesions in the spinal cord.

The syndrome, as a rule, occurs against the background of tumor diseases in the spinal cord, and much less often due to its injuries.

In addition, monoparesis is a common consequence of lesions of the precentral gyri, which arise from a cause in the anterior cerebral arteries.

When does the disorder most often occur?

Monoparesis can occur due to damage to the peripheral or central nervous system. Let's take a closer look at these violations.

The occurrence of the disease is most often associated with the fact that peripheral motor neurons are affected and their sensitivity is impaired.

With this type of paralysis, the muscles weaken significantly, and the muscles' resistance to gravity is reduced or completely absent.

Monoparesis, which is caused by lesions directly in the muscle tissues themselves, is extremely rare.

Lesions of the peripheral nervous system that may cause this syndrome include disorders such as radiculitopathy, plexopathy. In this case, the muscles weaken, sensitivity decreases, and pain occurs.

The rarest are monoparesis due to lesions of motor neurons in the central nervous system. This type of paralysis, which is a consequence of disturbances in the functioning of the central nervous system, is usually caused by embolic cortical infarction. In this case, paralysis affects the arms more often than the legs.

During the first days of disease development, central paresis is not easy to distinguish from peripheral paresis. This is due to the fact that the main signs of central paresis, such as spasticity, do not appear immediately.

What diseases are characterized by monoparesis?

Paresis (paralysis), one of the many subtypes of which is monoparesis, can occur due to many reasons, primarily associated with lesions of the brain and spinal cord.

As stated above, this disorder most often accompanies diseases caused by lesions of the central or peripheral nervous system. Due to the lesions, the conduction of signals in the nerves is disrupted, which leads to the development of the disorder.

In addition, the following phenomena can serve as an impetus for the development of monoparesis in the limbs:

Modern view of therapy

Since monoparesis is a secondary disease, that is, it occurs as a result of diseases, treatment methods should be aimed at combating the cause of paralysis. The following methods are used in the treatment process:

In conclusion, it should be mentioned that paresis of the limbs is a fairly serious disorder that significantly complicates a person’s life and can lead to dangerous consequences.

To avoid complications, the disease must be treated in the early stages of its development under the supervision of competent specialists.

The lower limbs are a very important part of the human body, thanks to them people can walk, live an active life and develop. If the legs begin to hurt, then the person suffers greatly, and paresis of the limb leads to incapacity and makes the patient disabled.

Paraparesis of the lower extremities is a serious disease that requires urgent medical attention and timely treatment. Prolonged paresis of the limbs can become irreversible, then the patient will forever remain confined to a wheelchair.

Many people are interested in what paresis of the limbs is, and why it occurs. Paresis of the lower extremities is a weakness of the leg muscles, which occurs due to a disruption in the connection of tissues with the nervous system, which in turn occurs due to pathological conditions of the spine and brain. Paresis can also occur due to injury to peripheral nerves.

The disease is divided into flaccid and spastic paresis. Flaccid is more dangerous; in such a situation, the muscles not only stop working due to the lack of nerve impulses, but also constantly weaken and atrophy. With spastic paresis, increased muscle tone is observed, but the tissues do not atrophy.

Depending on the affected area, paresis is divided into the following types:

• With paraparesis, symmetrical damage occurs to different parts of the body, for example, two legs or two arms.
• Monoparesis is characterized by damage to one limb;
• With hypereparesis, there is a disruption in one half of the body;
• Tetraparesis is characterized by damage to all limbs in the human body;
• Triparesis paralyzes three limbs.

Also, depending on the severity of paresis, it is divided into mild, moderate and deep.

Causes

There are several causes of diseases. If one leg is affected, then most likely the cause of the pathology is damage to the peripheral nerve, but if the functioning of both limbs is impaired, the disease is most likely associated with a disorder in the spinal cord or brain.

The following situations can provoke pathology:

• Injuries to the leg, back, head;
• Various tumors that, as they increase, compress the nerve;
• Multiple sclerosis;
• Abscess in the spine;
• Spinal cord injuries: immune, infectious, toxic;
• Spinal stenosis;
• Blockage of the artery supplying the spine;
• Avitaminosis, a lack of B vitamins and folic acid, which nourish the nerves.

Symptoms

Paresis of the muscles of the lower extremities is accompanied by the following symptoms:

• Impaired skin sensitivity;
• Over time, the patient cannot feel pain, hot or cold;
• The patient is bothered by pain;
• Spastic paraparesis is characterized by tension in the leg muscles;
• In the flaccid form, muscle weakness is observed;
• Knee reflexes are impaired;
• The patient cannot walk normally, limps, tries to walk carefully and slowly.
• In severe cases, disturbances in urination and defecation are observed.

Symptoms usually develop quite quickly, in some cases there is temporary relief, while in others the limbs become increasingly weaker. Often paresis of the limbs is accompanied by a difficult moral state; the patient does not want anything and refuses to eat.

There may also be a deterioration in the general condition, for example, weakness, nausea, dizziness, fever, problems with blood pressure. At the same time, the functioning of the immune system is disrupted, and the body becomes susceptible to infectious diseases.

In children

Paresis can also occur in childhood, in which case the disease can be congenital or acquired. Acquired childhood paresis is usually associated with birth trauma, and congenital paresis with pathology of bone marrow and brain development. In both cases, the child must undergo a course of treatment from a neurologist, otherwise he will begin to lag behind in development.

It is quite difficult to identify paresis in a child, since often there are no obvious symptoms of the pathology. As a rule, an experienced neurologist can detect the disease already at the initial examination, since the sick child has some deviations from the norm. For example, muscles may be too relaxed or tense.

Parents need to show their child to a neurologist as soon as possible if the baby takes his first steps on his toes, he is very restless, sleeps and eats poorly, and there is also a tremor of the chin. These symptoms are not always a sign of paresis, but it is necessary to undergo an examination.

Diagnostics

It is very important to diagnose the pathology promptly and correctly in order to prescribe the correct treatment. Therefore, if unpleasant symptoms appear, such as weakness in the legs, loss of sensitivity, you should immediately consult a therapist and neurologist for advice.

The doctor will examine the patient, take a medical history, perform physiological tests, and check reflexes. A qualified specialist will detect the pathology at the first appointment, and to confirm and clarify the diagnosis, prescribe tests:

• Blood analysis;
• Cerebrospinal fluid analysis;
• Tests for deficiencies of folic acid and B vitamins.

Treatment

Spastic paraparesis and its other types should be treated under the supervision of a specialist. Treatment of the disease is complex and long-term, in most cases conservative. The doctor prescribes medications, physiotherapy, massage and therapeutic exercises.

For paresis, the following groups of medications are prescribed:

• B vitamins and folic acid;
• Cholinesterase inhibitors, these drugs stimulate the transmission of nerve impulses to muscles;
• Nonsteroidal anti-inflammatory drugs are indicated for pain relief;
• Antispasmodics and muscle relaxants are prescribed for muscle hypertonicity.

The psychological state of the patient also plays an important role, therefore, for anxiety and depression, a consultation with a psychologist is indicated. In addition to medications, the patient must be advised to follow a diet. It is necessary to eat a balanced diet and consume more foods that have a positive effect on nerve cells.

Physiotherapy, massage and physical therapy are prescribed from the first day of treatment. These procedures will help improve blood circulation in the tissues, thus speeding up recovery. In addition, regular muscle work will prevent muscle atrophy.

Surgical treatment is rarely prescribed; it is usually carried out to remove a hernia, tumor, hematoma, which can compress the nerve, thus disrupting the conduction of impulses and tissue sensitivity. Surgery is also indicated for severe injuries, when there is a nerve rupture and it needs to be restored.

Folk

In the complex treatment of paresis, you can use folk remedies, but you should not self-medicate as this can be dangerous. It must be remembered that traditional medicine recipes are not a panacea, but only an excellent symptomatic remedy that will help get rid of pain and other pleasant sensations, but cannot completely cure the disease.

• For spastic paraparesis, taking chamomile decoction orally helps well; it soothes and has anti-inflammatory effects. You should drink the decoction every day instead of tea during meals, and also before bed.
• Rosehip is very useful for restoring nerves; it should be brewed and consumed internally. For the best effect, it is recommended to brew rose hips and hawthorn fruits; to do this, place them in a thermos, pour boiling water over them and leave them overnight. In the morning you need to add a little honey to a warm drink for sweetness and drink it all day, but no more than a liter per day.
• Traditional healers recommend treatment with juices; they will help strengthen the body and speed up recovery. For paresis, it is recommended to drink a cocktail of carrot, red beet and celery juice.
• To relieve muscle spasm, it is recommended to rub the affected muscles with valerian tincture, but the movements should not be too active, you need to rub gently and carefully.
• Contrast baths are very effective for paresis; they will improve blood circulation and muscle nutrition. For this procedure, you need to prepare two baths of water, pour hot into one, and cold into the other, and dip your feet in them alternately. The duration of the procedure should be no more than 20 minutes.

Prevention

To prevent the development of paresis of the lower extremities, it is necessary to avoid factors that can provoke it. It is very important to treat all injuries in a timely manner and do not neglect visiting a specialist. It is also recommended to lead a healthy lifestyle, eat a balanced diet and avoid vitamin deficiency.

To avoid paresis in the child, the mother should be regularly observed in the antenatal clinic, starting from 7-9 weeks, undergo ultrasound, medical examinations and take all necessary tests. It is also very important to eat right, avoid strenuous work, and protect yourself from stress.

During childbirth, the mother must listen carefully to the midwife and carry out all the actions that are recommended to her. In turn, doctors must carry out any manipulations with caution so as not to injure the newborn.

It is very important to regularly show the child to a neurologist in the first year of life. In the event of a developmental disorder, the doctor will be able to quickly identify the pathology and prescribe adequate treatment. It must be remembered that the earlier measures were taken, the more favorable the prognosis.

About paresis (video)

Paresis is a neurological syndrome accompanied by weakness of the legs and the inability to perform voluntary movements. The disease develops when the nerve trunks of the brain and spinal cord are damaged, against the background of myopathies, neuropathies, and disturbances in the peripheral innervation of tissues. Paresis of the lower extremities can affect one or both legs, cause muscle atrophy, or, conversely, be accompanied by selective hypertonicity.

Essence of the disease

Pathological processes arise due to dysfunction in the transmission of impulses to the distal parts of the limbs due to primary damage to the medulla or injury to the nerve trunks.

The cause of disruption of soft tissue innervation may be a disorder in the processes of excitation, agility, inhibition and balance in the cerebral cortex.

Depending on which neurons are affected, spastic, flaccid and mixed paresis are distinguished. In the first case, the muscle tone of the lower extremities increases, hyperreflexia is noted, the patient makes fast, rhythmic movements caused by jerky contractions of a separate muscle group. With peripheral paraparesis, patients are diagnosed with hypotension, lack of protective reflexes, and synkinesis. The mixed form combines the symptoms of the previous two.

Causes

The disease is caused by the following factors:

• intervertebral hernia;
• metastasis of malignant tumors to the brain and spinal cord;
• Guillain-Barré syndrome;
• stroke;
• rheumatoid arthritis of the cervical spine;
• myasthenia gravis;
• metabolic myopathy;
• polyneuropathy;
• radiculitis;
• traumatic brain injuries;
• neurosyphilis;
• plexitis;
• encephalitis;
• botulism;
• birth injuries;
• multiple sclerosis.

Paresis of the lower extremities is not an independent disease, but occurs when the motor pathway from the brain neuron to the peripheral nerve ending is disrupted. Damage to any area along this segment inhibits the transmission of impulses to the muscle, causing weakness in the legs and impaired mobility.

Classification

Based on the number of limbs involved, paresis is divided into:

• monoparesis - damage to one leg;
• paraparesis – paralysis of both legs;
• hemiparesis - impairment of motor functions of the arm and leg on the left or right side of the body;
• tetraparesis - damage to all limbs.

The development of monoparesis most often occurs with pathologies of the peripheral nervous system: muscle weakness spreads to the sections innervated by the pinched root. Hemiparesis has a central etiology and is diagnosed in diseases of the brain.

Signs of paraparesis of the lower extremities in adults often occur when the cauda equina is compressed by an intervertebral disc. In such cases, asymmetrical damage to the legs is observed, the disease causes intense pain, decreased sensitivity, urinary and fecal incontinence, and numbness of the perineum.

Tetraparesis is diagnosed in various myopathies, neuropathies, polymyositis, and poliomyelitis. The pathology develops acutely, causes paralysis of the respiratory system, and poses a direct threat to human life.

Depending on the severity, paraparesis is classified into mild, moderate, deep stage and complete paralysis (lack of mobility). Most often, hypotonia of one muscle or any group is diagnosed, or a certain part of the limb is affected (distal, proximal).

Symptoms

Clinical manifestations depend on the type of disease. With central paresis, there is an increased tone of some muscle parts of the pyramidal type, but there are no signs of malnutrition. Deep motor reflexes are clearly expressed, while superficial ones are weakened, pathological flexion and extension reactions appear. Characteristic is the appearance of friendly movements of the affected limb as a reaction to an action performed by a healthy one.

Increased tendon reflexes lead to causeless or induced clonus of the foot and buttocks. There is a dorsal extension-flexion of the thumb, a fan-shaped opening of the phalanges. Movements appear in response to external influence (pinch, injection).

With peripheral paraparesis, hypotension is observed up to a complete loss of muscle strength in the proximal parts. Due to a violation of the nervous innervation, atrophy develops, the volume of soft tissues decreases, reflex reactions are weakened, and sensitivity decreases. In rare cases, involuntary contractions of fibers may occur: a similar symptom is observed when the anterior horns of the spinal cord are damaged.

With spastic paresis, the patient cannot lift the leg or bend it at the joint, so the gait changes and the limb drags along the ground.

Patients suffering from flaccid paraparesis cannot move without additional support, since weakened muscles cannot cope with body weight. The limbs are in an unnatural position, coordination of movements is impaired.

Diagnostics

Establishing a diagnosis is not difficult; the doctor can easily determine the disease after an examination. Muscle strength is assessed on a five-point scale:

• 5 – all reflexes are preserved, muscle strength is normal, the patient is healthy;
• 4 – there is a decrease in strength, but the patient can make active movements, overcoming the resistance of the doctor’s hand;
• 3 – a person is able to perform habitual movements, but cannot cope with resistance;
• 2 – the patient does not overcome gravity;
• 1 – movements are minimal or completely absent.

In the initial stages of the disease, the resistance test may not give the correct results; in such cases, the Barre test is additionally performed. The patient must hold the limb suspended for a long time; if the muscles weaken, the leg will begin to fall within the first 20 seconds.

Paraparesis of the lower extremities in children is diagnosed by pain localization. At the initial stage, children complain of discomfort, rapid fatigue, later their gait changes, paralysis and convulsions develop. The rate of progression of the disease is very high. Most often, the pathology occurs against the background of cerebral palsy or other diseases of the nervous system.

In case of brain damage, an encephalogram, a skull x-ray with contrast, and radioisotope research methods and electromyography are used.

Congenital paraparesis is diagnosed by decreased reflexes, low physical activity, hypotension or hypertonicity of the muscles of the lower extremities. Children have tremor of the arms and legs, increased excitability and other neurological disorders.

Treatment

Therapy for paresis is carried out comprehensively. It is important to identify the primary cause of the pathology in order to try to restore innervation to the lower extremities. To improve trophism, heat is applied to the legs, massage is performed, exercise therapy is performed, and hardware and robotic methods are used.

In case of bulbar, ascending paralysis, spinal amyotrophy of Werdnig-Hoffmann, the patient must be urgently hospitalized and provided with artificial ventilation, since paresis affects not only the limbs, but also the muscles of the respiratory tract.

Medicines

In case of paraparesis of the lower extremities, drug treatment is carried out to eliminate the primary disease, restore the functioning of the nervous and cardiovascular systems and relieve pain.

Antibiotics are prescribed for the treatment of infectious diseases. Angioprotectors and nootropics normalize blood pressure and blood supply to the brain. When tumors, intervertebral hernias, or post-traumatic hematomas form, surgical intervention is required. To maintain basic body functions and strengthen weakened tissues, patients are prescribed B vitamins and immunomodulators.

If spastic paraparesis of the lower extremities is diagnosed, skeletal muscle relaxants are prescribed: Sirdalud, Tizanil. These drugs relieve hypertonicity and reduce pain, and have a sedative effect in case of neuroses and increased excitability.

Physiotherapy

Performing physiotherapeutic procedures can increase nerve conduction into weakened muscles and improve the effect of medications taken. People suffering from paraparesis of the legs are prescribed:

• impulse currents;
• electrophoresis with calcium and novocaine;
• microwave therapy;
• electromyostimulation;
• cryotherapy;
• thermal procedures: paraffin, ozokerite;
• UV irradiation.

During the recovery period, patients take mud, nitrogen-silicon, thermal, sulfide and radon baths. A course of physiotherapy is prescribed by the attending physician, taking into account the severity and type of disease, but not earlier than 2-3 weeks from the start of treatment.

Physiotherapy

After the patient is able to sit independently, special physical exercises begin to work out the muscles. A specialist teaches a person to stand and walk using mobile playpens, walkers, three-legged crutches, and a cane.

Later, the patient is taught to place the foot correctly; to do this, you need to climb the stairs or the trail. The course of exercise therapy lasts at least 2–3 months. The recovery period for paraparesis is quite long, so the patient must perform a set of exercises independently at home after discharge from the hospital for about 1.5–2 years.

As motor activity returns and general condition normalizes, you can visit the pool, jump on a trampoline, and jog. The speed of rehabilitation depends on the desire and persistence of the patient.

Massage

With the help of therapeutic massage, weakened tissues are restored. Procedures begin at 2–3 weeks. With central paraparesis, lightly stroking the muscles of the injured limb is performed, and in the area of ​​the second leg, on the contrary, the muscles are kneaded more vigorously.

Massage is carried out every day, the full course is 10–15 sessions. Additionally, the doctor performs passive manipulations of the paralyzed limb.

Folk remedies

In addition to basic methods of therapy, alternative medicine recipes can be used. Treatment with masks made of natural clay, external alcohol rubs made from walnut shells, St. John's wort, thyme, and calendula help well with paraparesis of the lower extremities.

It is useful to drink freshly squeezed vegetable and fruit juices, decoctions of chamomile, yarrow, juniper, oak bark, marshmallow and dandelion root. Home treatment should be agreed with your doctor!

Operation

Surgical intervention is indicated for flaccid paraparesis and cerebral palsy, if other treatment methods do not produce results. The main indications for the procedure are changes in the shape and axis of the limb, neurogenic deformities, and reflex muscle contractures.

Types of operations:

• tendon-muscle plasty;
• capsuloplasty, tenodesis;
• corrective osteotomy, arthrodesis, limb lengthening.

In advanced cases, several techniques are combined. An important role is played by the implementation of rehabilitation measures in the postoperative period.

Prevention