paralysis
(pă-ral'ĭ-sĭs 
, pă-ral'ĭ-sēz‵)
Plural: paralyses
[Gr. paralyein, to disable]
- Loss of sensation; anesthesia.
- Loss of purposeful movement, usually as a result of neurological disease (such as strokes, spinal cord injuries, poliomyelitis), drugs, or toxins. Loss of motor function may be complete (paralysis) or partial (paresis), unilateral (hemiplegic) or bilateral (diplegic), confined to the lower extremities (paraplegic) or present in all four extremities (quadraplegic), accompanied by increased muscular tension and hyperactive reflexes (spastic) or by loss of reflexes and tone (flaccid). SYN: palsy. Patient Care: Rehabilitation therapists evaluate the patient's motor and sensory capabilities (muscle size, tone and strength, reflex or involuntary movement, response to touch or to painful stimuli). The patient must be positioned to prevent deformities. Passive range of motion is performed on the involved extremities to prevent contractures. The patient is repositioned frequently to prevent pressure sores. Local and systemic responses, including fatigue, are evaluated. The rehabilitation team assesses and attends to any self-care deficits the patient may have. Support is offered to the patient and family to help them deal with psychological concerns and the response to grief and loss. Assistance is provided to help the patient in achieving an optimal level of function and in adapting to the disability.
Important concerns include functional positioning, the prevention of deformities secondary to spasticity, and the prevention of injury when sensation is absent. A plan may be prescribed for muscle reeducation and compensatory training. Functional orthoses and assistive technology devices may be necessary to assist the patient in performing self-care and other tasks of daily living.
p. of accommodation Inability of the ciliary muscles to alter the lens to focus on near or far objects.
alcoholic p.Paralysis caused by the toxic effect of alcohol on spinal nerves. SYN: alcoholic paraplegia.
birth p.Loss of function due to nerve injury during delivery. Trauma to the baby during delivery may result in damage to the brachial nerves, facial nerves, or diaphragm. Asymmetrical movements or reflexes of the affected part are present. Prognosis depends on the amount of nerve damage sustained; permanent damage is rare. Most newborn paralyses resolve without sequelae within a few weeks or a few months after birth.SYN: birth palsy; brachial palsy; obstetrical paralysis.
brachial p.Paralysis arising from an injury received at birth to the brachial nerve.
brachiofacial p.Paralysis of the face and an arm.
bulbar p.Paralysis caused by changes in the motor centers of the medulla oblongata. SYN: progressive bulbar paralysis.
complete p.Paralysis in which there is total loss of function and sensation.
compression p.Paralysis due to prolonged pressure on a nerve, e.g., from improper use of a crutch or during sleep. SYN: pressure palsy; pressure paralysis.
conjugate p.Paralysis of the conjugate movement of the eyes in all directions even though the fixation axis remains parallel.
crossed p.Paralysis affecting muscles of one side of the face and those in the limbs on the opposite side of the body.
crutch p.Paralysis due to pressure on nerves in the axilla caused by improper use of a crutch.
decubitus p.Paralysis caused by compression of a nerve after lying on it, e.g., in sleep or a coma.
diphtheritic p.Paralysis of the muscles of the palate, eyes, limbs, diaphragm, and intercostal muscles as a complication of diphtheria. It is caused by a bacterial toxin. SYN: postdiphtheritic paralysis.
diver's p.Decompression illness.
SEE: Duchenne-Erb paralysis.
familial periodic p.A rare familial disease marked by attacks of flaccid paralysis, often at awakening. This condition is usually associated with hypokalemia but is sometimes present when the blood potassium level is normal or elevated. In affected individuals the condition may be precipitated by administration of glucose in patients with hypokalemia, and by administation of potassium chloride in those with hyperkalemia.
Acetazolamide is used to prevent either hypokalemia or hyperkalemia. Oral potassium chloride is given in attacks accompanied by hypokalemia.
flaccid p.Paralysis in which there is loss of muscle tone, loss or reduction of tendon reflexes, and atrophy and degeneration of muscles. It is caused by lesions of the lower motor neurons of the spinal cord.
ginger p.Jamaica ginger paralysis.
glossolabial p.Paralysis of the tongue and lips occurring in bulbar paralysis.
SEE: under Gubler, Adolphe.
hyperkalemic p.A rare form of periodic paralysis characterized by brief (1- to 2-hr) attacks of limb weakness. Respiratory muscles are involved in some cases. “Hyperkalemic” is misleading because the potassium levels may be normal. But, because an attack is precipitated by the administration of potassium, this form of paralysis is better termed “potassium-sensitive periodic paralysis.”
Emergency treatment is seldom necessary. Oral glucose hastens recovery. Attacks may be prevented by acetazolamide or thiazide diuretics.
hypokalemic periodic p.A form of periodic paralysis with onset usually before adulthood. An attack typically comes on during sleep, after strenuous exercise during the day. The weakness may be so pronounced as to prevent the patient from being able to call for help. The attack may last from several hours to a day or more. The diagnosis is established by determining that the serum potassium level is decreased during an attack.
Administration of oral potassium salts improves the paralysis. If the patient is too weak to swallow, intravenous potassium salts are required. Attacks may be prevented by oral administration of 5 to 10 g of potassium chloride daily.
hysterical p.Loss of movement without a demonstrable organic cause. Typically the patient's reflexes are preserved in the affected body part despite its apparent immobility, and bowel and bladder function are preserved. In Western medicine, functional disorders such as this are treated with occupational therapy or supportive psychotherapy; in traditional Chinese medicine, acupuncture is used.
SEE: Hoover sign.
immunological p.The inability to form antibodies after exposure to large doses of an antigen.
incomplete p.Partial paralysis of the body or a part.
infantile cerebral ataxic p.Cerebral palsy.
ischemic p.Volkmann contracture.
Jamaica ginger p.Paralysis due to polyneuropathy that affects the muscles of the distal portions of the limbs. It is caused by drinking Jamaica ginger, an alcoholic beverage containing the toxin triorthocresylphosphate.
SEE: Klumpke paralysis.
Land ry p.Flaccid paralysis that begins in the lower extremities and rapidly ascends to the trunk.
laryngeal p.Loss of vocal fold mobility. Common causes include surgical trauma to the recurrent laryngeal nerve or invasion of the nerve by a tumor. SYN: vocal paralysis.
lead p.Paralysis due to lead poisoning.
leaden p.Extreme fatigue, a symptom of atypical depression.
local p.Paralysis of a single muscle or one group of muscles.
mimetic p.Paralysis of the facial muscles.
mixed p.Paralysis of the motor and sensory nerves.
muscular p.Loss of the capacity of muscles to contract. It may be due to a structural or functional disorder in the muscle at the myoneural junction, in efferent nerve fibers, in cell bodies of nuclei of origin of the brain or of the gray matter of the spinal cord, in conducting pathways of the brain or spinal cord, or in motor centers of the brain.
musculospiral p.Saturday night palsy.
nuclear p.Paralysis caused by lesion of nuclei in the central nervous system.
obstetrical p.Birth paralysis.
ocular p.Paralysis of the extraocular and intraocular muscles.
postdiphtheritic p.Diphtheritic paralysis.
posticus p.Paralysis of the posterior cricothyroid muscles.
potassium-sensitive periodic p.
SEE: hyperkalemic paralysis.
SEE: under Pott, John Percivall.
pressure p.Compression paralysis.
primary periodic p.The occurrence of intermittent weakness, usually following rest or sleep and almost never during vigorous activity. The condition usually begins in early life and rarely has its onset after age 25. The attacks may last from a few hours to a day or more. The patient is alert during an attack.
The causes include hypokalemia, hyperkalemia, thyrotoxicosis, and a form of paramyotonia. Both forms of the disease in which potassium regulation is a factor respond to acetazolamide. The thyrotoxicosis-related disorder is treated by correcting the underlying thyrotoxicosis. Spironolactone is the treatment for cases of paramyotonia congenita with periodic paralysis.
progressive bulbar p.Bulbar paralysis.
pseudobulbar p.Paralysis caused by cerebral center lesions, simulating the bulbar types of paralysis.
pseudohypertrophic muscular p.
SEE: pseudohypertrophic muscular dystrophy.
radial p.Saturday night palsy.
Saturday night p.Saturday night palsy.
sensory p.Loss of sensation due to a structural or functional disorder of the sensory end organs, sensory nerves, conducting pathways of the spinal cord or brain, or the sensory centers in the brain.
sleep p.Brief, temporary inability to move or speak when falling asleep or awakening.
spastic p.Paralysis usually involving groups of muscles. It is caused by an upper motor neuron lesion and is characterized by excessive tone and spasticity of muscles, exaggeration of tendon reflexes but loss of superficial reflexes, and positive Babinski reflex.
Sunday morning p.Saturday night palsy.
supranuclear p.Paralysis resulting from disorders in pathways or centers above the nuclei of origin.
tick-bite p.Paralysis resulting from bites of some species of ticks whose saliva contains a toxin, esp. of the genera Ixodes and Dermacentor. It affects domestic animals and humans, esp. children, and causes a progressive ascending, flaccid motor paralysis. Recovery usually occurs after removal of the ticks.
SEE: Todd paralysis.
tourniquet p.Paralysis, esp. of the arm, resulting from a tourniquet being applied for too long a time.
vasomotor p.Paralysis of the vasomotor centers, resulting in lack of tone and dilation of the blood vessels.