Paraparesis

Paraparesis is a condition of a neurological disorder of the lower extremities of the body and sometimes even of the hands. This usually results in either a weakness in the legs or paralysis.

Once affected by this disorder, there is nothing you can do to cure it entirely. Therefore, patients are advised to take measures so that it doesn’t worsen any further or cause other complications.

There are basically two major types of Paraparesis:

• Tropical spastic Paraparesis
• Hereditary spastic Paraparesis

Tropical spastic Paraparesis

The alternate names of Paraparesis are HTLV-I-associated myelopathy or HTLV-I-associated myelopathy/Tropical spastic Paraparesis. This condition is caused mainly by the human t-lymphocytic virus or commonly known as HTLV. From the name, it is clearly evident that this virus is mostly found in the tropical parts and also in the Caribbean. The disease can also be caused due to serious trauma or nerve damage. The first attack is made on the spinal cord. Then gradually the virus breeds and spreads itself causing damage to the entire nervous system. People of the age group 30-40 are most prone to its attack.

Types of Tropical spastic Paraparesis

• Idiopathic TSP
• HTLV-I-associated myelopathy/Tropical spastic Paraparesis (HAM/TSP)

Tropical spastic Paraparesis Signs and symptoms

If the following symptoms are noticed in someone, he/she should immediately go through the diagnostic test for Tropical spastic Paraparesis:

• Severe back pain
• Problems related to dysfunctional urine
• Patches of red, itchy and scaly abnormal skin (Psoriasis)
• Instability in the legs
• Dysfunction in bowel movements
• Erectile problems

Other signs and symptoms

There are certain patients with TSP who show some other symptoms which include – sudden inflammation of eye’s uveal tract, swelling up of the tissues in lungs, swelling up of muscles, swelling of the joints (arthritis), constant drying up of the cornea etc.

How does it spread?

Besides being attacked normally, there are several other ways through which this virus might affect someone. That includes:

• Through breastfeeding (mother to child)
• Use of one’s contaminated needle on another
• Contagious blood transfusion
• From infectious vaginal sex
• Urinary dysfunction
• From any other contaminated sexual disease

Organs affected by Tropical spastic Paraparesis

• Spinal cord

• Urinary tract

• Muscles
• Limbs or hands

Tropical spastic Paraparesis Diagnosis

This disease although chokes the patient’s nervous system and causes severe numbness of the body, yet it is not life-threatening. People live for several years, after being diagnosed with it. The diagnosis can be in any of the following methods, as preferred by the doctor.

• Neurological test

In this test, the doctor finds out for any tingling sensation in the patient’s body, unbearable pain in the back, numbness of the hands or weakening of the legs.

• MRI scan

The neurological test might not always confirm the chances of Paraparesis in the patient. Therefore the doctor next suggests a full body MRI scan for checking if the spinal cord has swollen up.

• Lumbar puncture

The process of lumbar puncture is the final step for confirming someone with TSP. In this, traces of the disease-causing virus are identified along with signs of inflammation in the spinal cord.

Tropical spastic Paraparesis Treatment

Exact medication depends on the intensity of the disease and the age of the patient. Since it is a long-term treatment, one should be patient in dealing with it. Drugs for this include methylprednisone, antiretrovirals. To reduce the proviral load of HTLV-I, Valproic acid has been proved quite a success.

Hereditary Spastic Paraparesis

As the name suggests, this is an inherited neurological disorder which is detected by stiffness in lower limbs. It generally leads to the dysfunction of the spinal cord’s long axons. The condition is caused by an abnormality in the X chromosome. The alternative names for this include French settlement disease or Strumpell – Lorrain disease. It targets mainly the primary motor neurons of the body. It can attack people of both the genders.

Hereditary Spastic Paraparesis Signs and Symptoms

Some of the basic symptoms of this particular disorder include:

• Stiffness in the lower limbs
• Weakening of the muscles
• Improper speech
• Fatigue is very common
• Stumbling of the toes
• Problem in swallowing food

Other signs and symptoms

There can be some rare and more austere signs for this genetic disorder, like – epilepsy, breathing difficulty, mental retardation, ataxia, optic neuropathy or deafness. People of any age group, whether be an infant or a 60-year-old man can be affected by this.

Hereditary Spastic Paraparesis Causes

As it is a genetic disease, therefore inheritance of it always carries maximum chances of getting affected by this. It can generally be inherited via three modes and they are – autosomal recessive, autosomal dominant, and X-chromosome-linked recessive. From over 70 genotypes, 50 of them have been found to be suffering from this condition.

Consequences

This type of Paraparesis can lead to more dangerous results on the patient’s body, compared to the earlier type. And they are as follows:

• Obvious degeneration of the axon nerves
• Causing harm to primary motor neurons
• Jaw jerks
• Other complicated neurological disorders

Hereditary Spastic Paraparesis Diagnosis

Even in this condition, people live for quite long. But a damage or constant pressure on normal bodily activities and nervous system weakens them overall. The diagnosis includes mainly three steps which are as follows:

• To confirm that the patient is affected by particularly this form of Paraparesis and not any other disease, neurological tests and MRI scans are done.
• The doctor enquires about any member of the family with the similar disease.
• After the confirmation, the doctor precedes the initial treatment with blood tests.

Hereditary Spastic Paraparesis Treatment

Commonly used drugs are – Baclofen (to lessen the stiffness of the lower part of the body), Botulinum toxin (gives the muscle relief from overactivity), common antidepressants for patients that suffer from prolonged low mood due to such a disease. As the treatment is a lengthy one even in this regard, the medication doses are to be taken seriously and without any possible irregularities.

Physiotherapy for Paraparesis

For the gradual betterment of the muscular activity, regular physiotherapy is suggested. To reduce muscle stiffness or cramps, light physical exercises can be done by the patient. But remember not to overwork or exhaust by muscles by stretching yourself too hard. That can always have adverse effects like tearing of the ligaments etc. Aerobic fitness exercises include walking, swimming, bicycling.

Medical References:

ncbi.nlm.nih.gov

https://en.wikipedia.org/wiki/Hereditary_spastic_paraplegia

merckmanuals.com

medicinenet.com