Paralysis in children, causes of paralysis. Rehabilitation complex for the treatment of patients with flaccid paralysis

For voluntary movements human body responds to two groups of neurons, namely peripheral and central. They have different structure and differ in the functions they perform. Therefore, the manifestations of the disease vary.

When there is a disturbance in the functioning of central neurons, spastic paralysis develops, while when there are deviations in the functioning of peripheral neurons, flaccid paralysis occurs.

Central paralysis provokes a general disorder motor activity. A person develops spasticity of muscle fibers, but at the same time they do not lose their integrity and do not undergo atrophy. With the development of central paralysis, clinical convulsions appear in certain groups of muscle tissue, but deep tendon reflexes are completely preserved.

With this form of paralysis, a positive Babinski sign often appears, in which thumb the lower limb performs a flexion movement when the foot is irritated.

For paralysis peripheral nature there is a decrease muscle tone and atrophic processes develop. In this case, there are no deep tendon reflexes, while abdominal reflexes are preserved. Also characteristic of this form of paralysis is negative symptom Babinsky. People often complain of loss of sensitivity.

Species

There are different types diseases - classification is carried out depending on the severity of disorders, manifestations and prevalence of the pathological process. So, doctors distinguish between complete and incomplete paralysis. It can also be reversible or irreversible, local or widespread.

Depending on the affected area there is:

To indicate the number of limbs affected by the pathological process, doctors use the following terms:

Paralysis as a separate disease

In most cases, paresis and paralysis do not act as independent diseases. They are a symptom that indicates organic lesions of the central nervous system. However, there are some types of paralysis that are independent diseases.

Bulbar	This disease can have 2 types - acute and progressive. The basis acute form pathology is polio. At the onset of the disease, a person develops fever and severe headache. In this case, there is no discomfort in the muscles. Bulbar palsy results from damage to the structures and pons medulla oblongata. This process provokes disruption of organ function oral cavity– a person loses the ability to hold food in the mouth and speak normally. In some cases, the symptoms of the disease are accompanied by mono- or hemiplegia. Symptoms of the pathology increase over a short time, and breathing and heart contractions become arrhythmic. After a few days, the patient may die. If the outcome is positive, the person’s functions are partially restored. In case of progressive bulbar palsy A similar process takes place, but it proceeds much more slowly. The causes of this pathology have not yet been established. It is known that it is more common in middle-aged men. Unfortunately, there is no effective treatment for this disease, and therefore fatal outcome occurs within 1-3 days.
Bella	This condition is characterized by paralysis, which is accompanied by damage facial nerve. This disease is considered quite common. The main reasons for its development include infectious diseases, tumor formations, hypothermia, and surgical interventions. The main symptom of the pathology is severe pain, reminiscent of a migraine. This condition is also characterized by complete immobility of half the face. Such patients have difficulty speaking and eating. Muscles can completely atrophy or after certain time recover - it all depends on the cause of the disease.
Supranuclear	Progressive supranuclear palsy is extremely rare. This is a degenerative pathology of the central nervous system, which is characterized by gliosis and death of neurons in the midbrain, cerebellar nucleus, and basal ganglia. Reason of this disease is a disruption of the connections between the gaze centers, which are located in the brain stem and cortex. It is characterized by gaze paralysis, which is accompanied by the absence of friendly eye movements. Similar problems can be observed in the vertical or horizontal plane.
Larynx	Paresis and paralysis of the larynx may be associated with compression of this part of the body by certain structures, traumatic injuries or involvement of nerves in an abnormal process. Such paralysis can be supranuclear, which, in turn, is divided into cortical and corticobulbar, as well as bulbar. Thus, cortical palsies are always bilateral in nature and are the result of congenital cerebral palsy, diffuse atherosclerosis, and encephalitis. Corticobulbar palsy occurs when there is a lack of blood circulation in the area vertebral artery. And the bulbar form of the disease often occurs with polio, syphilis, rabies, polysclerosis, etc.
Peripheral, flaccid	This form of paralysis develops with profound changes in the neurons of the spinal cord and manifests itself in the form of partial loss of reflexes, atrophy of muscle tissue and loss of tone. Also, with this diagnosis, the functioning of the reflex arc is disrupted. Peripheral paralysis in some cases provokes sudden muscle twitching. With this form of the disease, the reaction of muscle tissue to the influence of electric current changes. IN in good condition it provokes its contraction. If the muscles are affected by paralysis, they lose the ability to adequately respond to the current and degeneration processes develop.
Landry, Rising	This type of paralysis is acute illness nervous system. It is characterized by defeat lower limbs, which sequentially passes to the upper cranial nerves. This pathology has an acute course and ends in death. Most cases of Landry's nerve palsy result from infection. acute infections– these include diphtheria, pneumonia, whooping cough, rabies, sepsis.
Accommodations	This paralysis is a visual impairment at close range. This disease can be a consequence of various neurological diseases, the use of certain medicines and contusions of the eyeball. Paralysis of accommodation manifests itself as complete violation vision at close distances. In this case, the closest point clear vision moves away from the eye so much that it merges with a further point.
Dejerine-Klumpke	This paralysis is a type partial defeat lower branches brachial plexus. It is characteristic of him peripheral paresis or paralysis of the muscle tissue of the hand. Also in the affected area, sensitivity changes and vegetative-trophic disorders are observed, including pupillary disorders. Symptoms of this disease include deep muscle paralysis of the hands. It is also characterized by numbness in the area of innervation ulnar nerve. Anesthesia affects the inner surface of the shoulder, hand and forearm.
Progressive, Bayle's disease	This disease is organic lesion brain, which is of syphilitic origin and is determined by the rapid development of dementia. At the same time, it is typical for patients neurological manifestations and cachexia. Progressive paralysis usually develops between the ages of 30 and 55, about 10 to 15 years after contracting syphilis. Initially, a person experiences asthenia or depression. Such problems are always accompanied by memory impairment, headaches and dizziness, increased irritability. Then symptoms of total dementia may increase or psychosis may develop.
Polio	This term means viral infection, which is characterized by pronounced manifestations acute intoxication, painful sensations in the muscles, damage to the nervous system and symptoms of dyspepsia. As a rule, with this pathology paralysis of the lower extremities and torso appears. Sometimes the neck muscles are also affected. Most serious consequence The disease is paralysis of the respiratory muscles. If their function is impaired, breathing stops and the patient dies. Thanks to timely treatment it is possible to stop the pathological process and gradually restore the functioning of muscle tissue. After pathology, atrophic disorders and deformations of the torso may be present.
Parkinson's disease (shaking)	This disorder is more common among older people. It is caused by the death of neurons located in the substantia nigra of the brain. The reason also lies in a decrease in the synthesis of dopamine, which is involved in the process of impulse transmission. As a result, a person develops trembling in the limbs and head, the tone of muscle tissue increases, stiffness appears and the ability to move in space is impaired. People with this diagnosis are unable to perform activities that require precision. Gradually decreasing intellectual abilities and emotional deviations arise.

How to treat

In most cases, paralysis and paresis are not independent diseases. That's why effective treatment impossible without adequate therapy main pathology.

If a peripheral nerve is damaged, its integrity must be restored. For this purpose, a neurosurgical operation is performed.

If a person has had a stroke, he needs to undergo full course rehabilitation treatment. If a tumor appears that compresses nerve endings or brain structures, it should be removed.

Therapy of paralysis in the event of a stroke requires restoration of the affected area and activation of neighboring zones that are able to take on lost functions. Several categories of drugs are used for this:

Of no small importance is symptomatic treatment diseases. To restore the function of the limbs, it is very important to position them correctly on the bed. This will reduce the risk of developing contracture.

An important component complex therapy is physical therapy and massage. By kneading the affected limbs and stimulating nerve endings muscles, it is possible to restore broken connections with the central zones of the cortex.

Peripheral paralysis responds well to electrotherapy and other physiotherapeutic techniques. Most often, doctors prescribe galvanization and balneotherapy. In this case, massage and special exercises are also very effective.

There are no therapeutic exercises to treat facial paralysis, and therefore such types of therapy are considered ineffective. Thanks to the use of drugs, it is possible to stimulate the restoration of the myelin sheath and the transmission of impulses.

For this purpose, B vitamins, aloe, vitreous. The same drugs are used during the rehabilitation period after surgery to restore the integrity of the nerves.

Neuropathies of a tunnel nature can be successfully treated with local drug blockades. During this procedure, painkillers and anti-inflammatory drugs are injected into the affected area and vitamin preparations. Thanks to this in short terms it is possible to restore muscle mobility.

Paralysis is a fairly serious condition, which in most cases is a symptom of more dangerous pathologies. To cope with this disease, it is very important to establish the causes of its occurrence, and for this it is important to consult an experienced doctor as early as possible.

Leg paralysis is a loss of motor ability caused by damage to the spinal cord. Paralysis can be complete or partial. In the second case they talk about paresis. Paralysis may indicate development large number diseases. If the limbs are paralyzed, you should carefully monitor the dynamics of changes in the condition....

Paralysis and paresis. The reasons for their occurrence

Paralysis is one of the types of impairment of human motor activity and manifests itself in its complete loss (Greek. paralysis- relaxation). This disease is a symptom of many organic diseases of the nervous system.

In case of incomplete loss motor function, but only by weakening it to one degree or another, this disorder will be called paresis(Greek paresis- weakening). Moreover, in both the first and second cases, motor dysfunction is the result of damage to the nervous system, its motor centers and/or pathways of the central and/or peripheral parts.

Paralysis should be distinguished from movement disorders that occur due to muscle inflammation and mechanical damage osteoarticular apparatus.

Paresis and paralysis - movement disorders, which are due to the same reasons.

The main causes of these diseases.

Paralysis is not caused by any one specific factor. Any damage to the nervous system can lead to impaired motor function. Congenital, hereditary and degenerative diseases central nervous system are usually accompanied by movement disorders.

Birth injuries - common reason cerebral palsy, as well as paralysis due to damage to the brachial plexus. Unfortunately, over 15 million patients with cerebral palsy have already been recorded in the world.

A number of diseases of unknown origin (for example, multiple sclerosis) is characterized motor disorders varying degrees gravity.

Circulatory disorders inflammatory processes, trauma, tumors of the nervous system can also cause paralysis or paresis.

Often paralysis is of a psychogenic nature and is a manifestation of hysteria.

The causes of paralysis can also be divided into organic, infectious and toxic.

TO organic reasons include:

Malignant neoplasms;
Vascular lesions;
Metabolic disorders;
Intoxication;
Eating disorders;
Infections;
Injuries;
Multiple sclerosis;

TO infectious causes include:

Meningitis;
Polio;
Viral encephalitis;
Tuberculosis;
Syphilis.

TO toxic reasons include:

Vitamin B1 deficiency;
Nicotinic acid deficiency;
Heavy metal poisoning;
Alcoholic neuritis.

Paralysis can be observed in one muscle, one limb ( monoplegia), in the arm and leg on one side ( hemiplegia), in both arms or both legs ( paraplegia) (the suffix plegia means paralysis).

By localization lesions distinguish two groups of paralysis, significantly different clinical manifestations: central ( spastic) and peripheral ( sluggish).

Central paralysis occur when central motor neurons are damaged. They are characterized by:

hypertonicity (increased muscle tone), for example, the “jackknife” phenomenon;
hyperreflexia (increased intensity of deep reflexes), especially demonstrably with unilateral damage;
the presence of pathological reflexes (Babinsky, Bekhterev, Astvatsaturov, etc.);
the appearance of pathological synkinesias (friendly movements), for example, when a patient voluntarily clenches a healthy hand into a fist and does not voluntarily repeat this movement with the affected hand, but with less force;
the appearance of clonus (convulsive muscle contractions in response to an impact), for example, foot clonus - when a patient lying on his back, with the affected leg bent at the hip and knee joints, the doctor performs dorsal extension of the foot, and the flexor muscles begin to involuntarily contract rhythmically , the rhythm can be maintained for a long time or fade out almost immediately.

Peripheral paralysis (flaccid) characterized complete absence movements, loss of muscle tone, extinction of reflexes, muscle atrophy. With damage to the peripheral nerve or plexus, which contains both motor and sensory fibers, sensitivity disorders are also detected.

When the subcortical structures of the brain are damaged, extrapyramidal paralysis, automated movements disappear, motor initiative is absent. Muscle tone is characterized by plasticity - the limb is held in a passive position given to it.

Classification

There are two scales for assessing the severity of paralysis (paresis) - by the degree of decrease in muscle strength and by the degree of severity of paralysis (paresis), which are the opposite of each other:

1. 0 points “muscle strength” - none voluntary movements. Paralysis.
2. 1 point - barely noticeable muscle contractions, without movements in the joints.
3. 2 points - the range of movements in the joint is significantly reduced, movements are possible without overcoming the force of gravity (along the plane).
4. 3 points - a significant reduction in the range of movements in the joint, the muscles are able to overcome the force of gravity and friction (in fact, this means the possibility of tearing the limb off the surface).
5. 4 points - slight decrease in muscle strength, with full range of motion.
6. 5 points - normal muscle strength, full range of movements.

Most significant features peripheral paralysis are:

1. atony (decreased tone) of muscles;

2. muscle atrophy due to decreased nerve trophism;

3. fasciculations (involuntary contractions of individual muscle fibers, perceived by the patient and visible to the doctor’s eye), which develop when large alpha motor neurons of the anterior horns of the spinal cord are damaged.

Determination of the stage of paralysis (paresis.)

An external examination can detect deformities of the spine, joints, feet, hands, asymmetry of skeletal development, and leg length.
Swelling of the legs, arms, changes in the trophism of the nails, skin, folding of the skin over the spine, stretch marks, varicose veins veins, areas of skin pigmentation, tumors, burn scars.

The most common method of examining muscles, bones and joints is palpation. Palpation of muscles is the main method of determining their tone.

Hypotension (decreased tone) is observed in cases of pure pyramidal paresis, in violation of muscle-articular sensitivity, in a number of neuromuscular diseases, cataplexy, attacks of sudden falling, hysterical paralysis, in lesions of the cerebellum, etc.
With hypotension, the muscle is relaxed, spread out, has no contours, the finger easily sinks into the thickness of the muscle tissue, its tendon is relaxed, and greater mobility is noted in the corresponding joint. Hypotension can be mild, moderate, or severe.

Atony- lack of normal skeletal muscle tone and internal organs, developing as a result of insufficiency general nutrition, disorders of the nervous system, with infectious diseases, disorders of the glands internal secretion. With atony, movement is not possible.

At hypertonicity the muscle is tense, shortened, prominent, compacted, the finger has difficulty penetrating the muscle tissue, movements in the joint are, as a rule, limited in volume.

Spasticity or spastic paresis.

Paresis is characterized by a peculiar selective increase in tone in the adductor muscles of the shoulder, flexors of the forearm, hand, fingers and pronators of the hand. In the leg, hypertonicity is noted in the hip extensors and knee joints, adductor muscles of the thigh, plantar flexors of the foot and toes (Wernicke-Mann position). With repeated movements, the springy muscle resistance may disappear and the spastic posture is overcome - a “jackknife” symptom.

In conditions of a spinal lesion above the cervical enlargement, spastic hemi- or tetraplegia develops; damage at the level of the thoracic segments causes lower paraplegia.

With spastic paresis, a number of accompanying symptoms are noted:

1. Tendon-periosteal hyperreflexia with expansion of the reflex zone, clonus of the feet, hands, and lower jaw.
2. The most reliable of them is the Babinski reflex, which is caused by streak irritation of the outer part of the sole with a pen from the heel to the toes. In response, the first finger extends and the remaining fingers flex and fan out.
3. Hoffman reflex - increased flexion of the fingers of a dangling hand in response to pinch stimulation nail phalanx third finger.
4. Protective reflexes - a triple flexion reflex of the leg when the skin of the foot is irritated by a pinch or a cold object, as well as a reflex of lengthening the leg in response to a thigh prick.
5. The absence of abdominal reflexes and signs of peripheral neuron damage (fibrillary muscle twitching, atrophy) complements the picture of spastic paresis.

Extrapyramidal pseudoparesis, rigidity.

Pseudoparesis manifests itself as uniform hypertonicity in massive muscle groups - agonists and antagonists, flexors and extensors of the limbs, which leads to a plastic increase in tone, freezing of the limb in its given state uncomfortable position(waxy flexibility).
Stronger flexors give the patient a “petitioner” posture. — The torso and head are tilted forward, the arms are half-bent at the elbow joints and pressed to the body. Movements are slow, awkward, and their initiation is especially difficult. When studying passive movements, intermittent muscle resistance is noted during flexion and extension of the limb. Rhythmic constant tremor of the fingers at rest is often observed.

Peripheral paresis (flaccid).

At flaccid paresis peripheral type pathological signs, synkinesis and defensive reflexes are missing.
Nerve damage (neuritis, mononeuropathy) leads to selective atrophy of the muscle group innervated by this nerve.
Polyneuritis contribute to symmetrical paresis of the distal muscles (feet, legs, hands, forearms).
Plexus lesion (plexite) accompanied by unilateral paresis with predominant localization in the upper or lower limbs, in the muscles of the pelvic or shoulder girdle.

Mixed paresis.

In some cases, patients simultaneously have signs flaccid paresis and symptoms of central damage motor neuron. This type of paresis is called mixed.
It causes damage to the cells of the anterior horn and pyramidal tract.
TO mixed type Paresis includes central type defects after strokes, with tumors (hematomas) with compression on this area. This category of patients presents together with hemiparkinsonism and spastic hemiparesis.

The treatment of such patients must be approached individually. Treatments for this disease include sulfur and radon baths, segmental and acupressure massage, balance therapy, and stem cell treatment. But the main method of treatment is special therapeutic exercises.

Description:

This neurological syndrome, which develops when a peripheral neuron is damaged, and is characterized by the loss of both voluntary and involuntary, or reflex, innervation.

Symptoms:

flaccid syndrome is characterized by the following signs[Duus P., 1995]:
- absence or decrease in muscle strength;
- decreased muscle tone;
- hyporeflexia or areflexia;
- or muscle atrophy.

Hypotonia and areflexia develop due to interruption of the arc of the monosynaptic stretch reflex and a disorder of the mechanism of tonic and phasic stretch reflexes. the muscle is caused by a violation of the trophic influence from the anterior horn on the muscle fibers, develops several weeks after denervation of the muscle fibers and can be so pronounced that after several months or years only the connective tissue remains intact in the muscle.

Causes:

Flaccid paralysis (paresis) develops when a peripheral (lower) neuron is damaged in any area: anterior horn, root, plexus, peripheral nerve.

Treatment:

For treatment the following is prescribed:

Restorative measures for the development of flaccid paresis or paralysis are aimed, firstly, at restoring (if possible) the function of a peripheral neuron, and secondly, at preventing the development of muscle tissue atrophy and prevention.

Function improvement nerve tissue is achieved by prescribing neutrotrophic and vasoactive drugs:

      * nootropil/piracetam (capsules/tablets 0.4 g-0.8 g three times a day or 20% solution 5-10 ml intramuscularly or intravenously);
      * Cerebrolysin (3-5 ml intramuscularly or intravenously);
      * Actovegin (5-10 ml intramuscularly or intravenously once or twice a day; 1 ml contains 40 mg of active substance);
      * trental (in pills, 0.1 g three times a day, or 5 ml intravenously once a day; 1 ml contains 0.02 g of active substance);
      * vitamin B1 (solution of thiamine chloride 2.5% or 5% or thiamine bromide 3% or 6%, 1 ml intramuscularly daily, once a day);
      * vitamin B12 (400 mcg 1 time every 2 days intramuscularly, can be combined with vitamin B1, but not in the same syringe).

If the anatomical integrity of the peripheral nerves is compromised, neurosurgical intervention may be indicated.

Prevention of development. Is very important task, since degeneration of denervated muscle fibers develops very quickly and is often irreversible. By the time innervation is restored (either through natural reinnervation or through neurosurgical intervention), atrophy can reach such a pronounced degree that muscle function can no longer be restored. Therefore, measures to prevent the development of muscle atrophy with impaired innervation should begin as early as possible. For this, massage is prescribed (classical, acupressure, segmental), therapeutic exercises, electrical stimulation of nerves and muscles.

Massage. It is aimed at stimulating muscles, so techniques include fairly intense rubbing, deep kneading, and impact on segmental zones. However, massage of paretic muscles should not be performed with great strength. The massage should be moderate and short-lived, but carried out over many months (short breaks are taken between courses). Rough, painful techniques can cause increasing muscle weakness. They also use acupressure using a tonic technique. Tonic method acupressure is carried out by applying vibrating, short, quick stimulation with the tip of the finger sequentially to a number of points that stimulate the desired movement.

During the polio eradication campaign, identifying all diseases that present with symptoms of acute flaccid paralysis, which may include people with undiagnosed polio, becomes especially important.

ACUTE FLACCID PARALYSIS

Diagnosis of PM is a complex process, including clinical, laboratory (virological) and special (ENMG) confirmation of the diagnosis with observation of paralysis for at least 2 months and requires certain experience and skills

Accurate diagnosis of PM in rural areas and in outpatient settings is sometimes an impossible task

Therefore, monitoring of cases suspected of PM is focused on identifying AFP, which clinical symptoms similar to PM

ACUTE FLACCID PARALYSIS

When diagnosing AFP, the following are taken into account:

History of present illness and previous life

Clinical symptom complex:

- feverish period

- meningo-radicular syndrome

- time of appearance and development of paralysis and paresis,

- nature of paralysis (flaccid or spastic).

- neurological status (reflexes, tone, sensitivity, pelvic functions, muscle atrophy and other symptoms),

- duration of paralysis, etc.

Sample collection time and results

Time of vaccinations and contact with vaccinated persons

Results of additional studies

ACUTE FLACCID PARALYSIS

Characteristics of acute flaccid paralysis

Presence of paresis (limitation) or paralysis (lack of range of motion in the limbs)

Low muscle tone

Low or absent tendon reflexes

Absence of pathological reflexes

Signs of damage to the anterior horns of the spinal cord

Diseases occurring with acute flaccid

I. polyradiculoneuropathy

paralysis

II. neuropathy of traumatic origin

III. musculoskeletal dysplasia IV. myelitis

V. polio VI. tumors

VII. other diseases (hematomyelia, spinal epidural abscess, myelino- and myelopathies and others)

Polyradiculoneuropathies

(Guillain-Barré, Landry, Strohl, Miller-Fisher syndrome,

acute polyradiculoneuritis)

Children are affected with a frequency of 1.1 per 100,000 population. The disease is often preceded by respiratory and

gastrointestinal tract

Etiology:

Campylobacter jejuni (30%)

cytomegalovirus (15%)

Epstein-Barr virus (10%)

Mycoplasma pneumoniae (5%), etc.

Polyradiculoneuropathies

There are 4 main clinical forms:

acute inflammatory demyelinating polyneuropathy (AIDP),

acute motor axonal neuropathy (AMAN),

acute motor-sensory axonal neuropathy (ASAN),

Miller-Fisher syndrome

Polyradiculoneuropathies

occur without a rise in temperature against the background of a generally satisfactory condition

gradual (over 1-2 weeks) development of neurological symptoms

in children with a feverish onset of the disease, the development of paresis/paralysis occurs against the background of normal temperature

paresis/paralysis begins in the distal limbs

are symmetrical

sensory disorders of the “stockings” and “gloves” type are observed

in the CSF there is often an increase in protein numbers with normal cytosis

by the end of the 3rd week of illness, 85% of patients show signs of segmental demyelination and/or axonal degeneration in an ENMG study

Neuropathies of traumatic origin

Most often, post-injection mononeuropathies are observed. When collecting anamnesis, it is possible to identify a connection with intramuscular injection that preceded the development of neuropathy

Other causes are less commonly identified: falls and spinal injuries, compression of a limb by a tight bandage, pinching of a limb in a crib or playpen

Neuromuscular diseases

“Floppy baby” syndrome can be observed in a number of diseases:

congenital muscular dystrophy

spinal progressive muscle atrophy(Werdnig-Hoffman, Fazio-Londe, etc.)

atonic form of cerebral palsy

benign form of congenital hypotension

some other diseases

Peripheral paralysis is a consequence of profound changes in the neurons of the spinal cord. It is expressed in the partial loss of reflexes, muscle atrophy, loss of muscle tone and disturbances in the functioning of the reflex arc. Peripheral paralysis sometimes results in sudden, uncontrollable twitching of the affected muscles.

With this type of disease, a change in the reaction of muscles to electric current is very characteristic. In normal condition, the muscle conducts electric current, which leads to its reduction. In the case of muscles affected by paralysis, the usual reaction does not occur in them, but processes are observed that are called the reaction of degeneration or degeneration.

With such reactions, the nerve does not pass current to the muscle, since its main fibers are either degenerated or destroyed, and the muscle itself loses the ability to contract in response to exposure to faradic current, leaving a reaction only to galvanic current. But even this reduction is happening much more slowly than usual. This condition occurs approximately 2 weeks after the onset of negative processes in the nerve. With partial damage to the motor neuron, an incomplete degeneration reaction occurs if the nerve's susceptibility to both types of current is not completely lost, but only weakened. These signs are necessarily present in any type of this paralysis.

Types of disease

Doctors distinguish between flaccid and spastic paralysis. Flaccid paralysis (the second name for peripheral paralysis) is accompanied by a decrease in muscle tone and even complete atrophy muscles. Spastic paralysis, on the contrary, is characterized by a large muscle tension. In this case, patients may even lose control of their muscles. This disease originates in the peripheral nerve, but the spastic one appears in various departments both the spinal cord and the brain.

But the data clinical types are not considered independent diseases, because the root cause of these syndromes are various factors. But there are some types of paralysis that are distinguished in individual diseases. For example, Parkinson's disease, polio in children, childhood cerebral palsy and others.

Acute flaccid paralysis is characterized by the following symptoms:

the muscle does not resist passive movements;
pronounced atrophy;
deep reflexes are reduced or absent;
change in electrical excitability of nerves and muscles.

These signs make it possible to separate patients with peripheral paralysis from patients suffering.

If patients with cent In case of peripheral paralysis, the muscle processes nerve impulses only coming from the spinal cord; in the case of peripheral paralysis, the muscle does not perceive any information. So if in the first case there is some semblance of muscle activity (constant spasm or tension), then in the second such activity is practically impossible.

There are also pathologies (for example, lateral amyotrophic sclerosis) with more extensive neuronal damage. Here the central and peripheral nerves. The subtype of the resulting paralysis is mixed, that is, it will have signs of both the first and second types. There will be 3 symptoms of acute flaccid paralysis: muscle weakness, atony and absence of typical reflexes. But due to the influences on spinal cord from neighboring nodes of the nervous system, a fourth symptom is added, already characteristic of central paralysis. These are atypical reflexes, but since the muscles are almost inactive, they will be very faintly noticeable and will fade away completely as the disease progresses.

Disease in children

One of the main problems of modern pediatrics is acute flaccid paralysis in children. Over the past 20 years, the number of cases of polio in children has decreased worldwide from 350,000 to 400 per year. But despite this, the risk of developing AFP in children due to widespread other non-polio enteroviruses.

There are also signs of acute flaccid paralysis in children, which is expressed by tremors and weakness in one or more limbs, as well as malfunction respiratory and swallowing muscles due to damage to lower motor neurons.

The main viral causes of this disease are various enteroviruses. Since polio is being systematically eradicated throughout the world through vaccination and prophylactic agents, there is a real danger that other neurotropic viruses will conquer its now almost empty niche and become the causes of acute flaccid paralysis. For example, enterovirus type 71 is now considered the most dangerous neurotropic virus, which often leads to epidemics of infantile flaccid paralysis. On the island of Taiwan, over the past 7 years, the total mortality among children under 14 years of age after enterovirus infection 71 types accounted for 16%.