Paraplegia, or paraparesis, is an impairment in motor or sensory function of the lower extremities. The word comes from

Ionic Greek Ionic or Ionian Greek () was a subdialect of the Eastern or Attic–Ionic dialect group of Ancient Greek. The Ionic group traditionally comprises three dialectal varieties that were spoken in Euboea (West Ionic), the northern Cyclades (Centr ...

() "half-stricken". It is usually caused by

spinal cord injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. It is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions. Symptoms of ...

or a

congenital A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...

condition that affects the neural (brain) elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the

thoracic The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main ...

lumbar In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm (anatomy), diaphragm and the sacrum. Naming and location The lumbar region is sometimes referred to as the lowe ...

, or sacral regions. If four limbs are affected by

paralysis Paralysis (: paralyses; also known as plegia) is a loss of Motor skill, motor function in one or more Skeletal muscle, muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory d ...

tetraplegia Tetraplegia, also known as quadriplegia, is defined as the dysfunction or loss of motor and/or sensory function in the cervical area of the spinal cord. A loss of motor function can present as either weakness or paralysis leading to partial ...

or quadriplegia is the correct term. If only one limb is affected, the correct term is

monoplegia Monoplegia is paralysis of a single Limb (anatomy), limb, usually an arm. Common symptoms associated with monoplegic patients are weakness, numbness, and pain in the affected limb. Monoplegia is a type of paralysis that falls under hemiplegia. W ...

Spastic paraplegia Hereditary spastic paraplegia (HSP) is a group of inherited diseases whose main feature is a progressive Gait abnormality, gait disorder. The disease presents with progressive stiffness (spasticity) and contraction in the lower limbs. HSP is als ...

is a form of paraplegia defined by

spasticity Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. ...

of the affected muscles, rather than

flaccid paralysis Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause (e.g., trauma). This abnormal condition may be caused by disease or by trauma affecting the nerves associ ...

. The American Spinal Injury Association classifies spinal cord injury severity in the following manner. ASIA A is the complete loss of sensory function and motor skills below the injury. ASIA B is having some sensory function below the injury, but no motor function. In ASIA C, there is some motor function below the level of injury, but half of the muscles cannot move against gravity. In ASIA D, more than half of the muscles below the level of injury can move against gravity. ASIA E is the restoration of all neurologic function.

Treatment

Individuals with paraplegia can range in their level of

disability Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, d ...

, requiring treatments to vary from case to case. Rehabilitation aims to help the patient regain as much functionality and independence as possible.

Physiotherapy Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease preventio ...

may help to improve strength, range of motion, stretching and transfer skills. Most paraplegics will be reliant on a

wheelchair A wheelchair is a mobilized form of chair using two or more wheels, a footrest, and an armrest usually cushioned. It is used when walking is difficult or impossible to do due to illnesses, injury, disabilities, or age-related health conditio ...

as a mode of transportation.

Activities of daily living Activities of daily living (ADLs) is a term used in healthcare to refer to an individual's daily self-care activities. Health professionals often use a person's ability or inability to perform ADLs as a measure of their Performance status, functi ...

(ADLs) can be quite challenging at first for those with a

(SCI). With the aid of physiotherapists and

occupational therapists Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's abil ...

, individuals with an SCI can learn new skills and adapt previous ones to maximize independence, often living independently within the community.

Regeneration of the spinal cord

Olfactory ensheathing cells Olfactory ensheathing cells (OECs), also known as olfactory ensheathing glia or olfactory ensheathing glial cells, are a type of macroglia ( radial glia) found in the nervous system. They are also known as olfactory Schwann cells, because they e ...

(OEC) have been transplanted with success into the spinal cord of a Polish man named

Darek Fidyka Dariusz "Darek" Fidyka (born ) is a Polish firefighter and recovering paraplegic who became the first person in history to verifiably recover sensory and motor function after the complete severing of his spinal cord. Having been paralysed fr ...

, who was the survivor of a knife attack that left him paraplegic in 2010. In 2014, Fidyka underwent pioneering spinal surgery that used nerve grafts, from his ankle, to 'bridge the gap' in his severed spinal cord and OEC's to stimulate the spinal cord cells. The surgery was performed in Poland in collaboration with Prof. Geoff Raisman, chair of neural regeneration at University College London's Institute of Neurology, and his research team. The olfactory cells were taken from the patient's olfactory bulbs in his brain and then grown in the lab, these cells were then injected above and below the impaired spinal tissue. Fidyka regained sensory and motor function in his lower limbs, notably on the side of the transplanted OEC's. Fidyka first noticed the success three months after the procedure, when his left thigh started gaining muscle mass. MRIs suggest that the gap in his spinal cord has been closed up. He is believed to be the first person in the world to recover sensory function from a complete severing of the spinal nerves.

References

External links

Spinal Cord Injury
at

The Mayo Clinic Mayo Clinic () is a private American academic medical center focused on integrated healthcare, education, and research. It maintains three major campuses in Rochester, Minnesota; Jacksonville, Florida; and Phoenix/Scottsdale, Arizona. Mayo C ...

Types of Paralysis
a
Spinalcord.com
{{Authority control Cerebral palsy and other paralytic syndromes Neurotrauma

Treatment

Regeneration of the spinal cord

See also

References

External links