Types of Paralysis

What Is Paralysis?

Paralysis is when you can’t move certain parts of your body after something goes wrong with their connection to your brain. It comes in many different forms and can be temporary or permanent, or even come and go.

Someone who is paralyzed because of a sudden injury often can’t feel or move anything at all in their affected body parts. Someone paralyzed by a medical condition, such as multiple sclerosis (MS), might feel tingling or muscle weakness.

Paralysis can cause problems with blood flow, breathing, how your organs work, speaking or swallowing, sexual responses, or controlling the urge to go to the bathroom, depending on where you’re paralyzed and how bad it is.

What is temporary paralysis?

Some people with paralysis regain their ability to move the muscles involved. So, their paralysis is temporary. For example, that happens with Bell's palsy, a type of facial paralysis. There's also a rare condition called periodic paralysis that causes sudden repeated attacks of muscle weakness, stiffness, or paralysis. The symptoms go away between attacks.

Types of Paralysis

Complete paralysis is when you can’t move or control your paralyzed muscles at all. You also may not be able to feel anything in those muscles.

Partial or incomplete paralysis is when you still have some feeling in and possibly control over your paralyzed muscles. This is sometimes called paresis.

Localized paralysis affects just one specific area, such as your face, hands, feet, or vocal cords.

Generalized paralysis is more widespread in your body and is grouped by how much of your body is affected. The type usually depends on where your brain or spinal cord is injured. These types include:

  • Monoplegia, which affects just one limb
  • Diplegia, whichaffects the same area on both sides, like both arms, both legs, or both sides of your face
  • Hemiplegia, which is on just one side of your body and is usually caused by stroke damage on one side of your brain
  • Quadriplegia (or tetraplegia), which is when all four limbs are paralyzed, sometimes along with certain organs
  • Paraplegia, which is paralysis from the waist down
  • Locked-in syndrome, the rarest and most severe form, where a person loses control of all their muscles except the ones that control their eye movements

Spastic paralysis vs. flaccid paralysis

Paralysis can be stiff, or spastic, when your muscles are tight and jerky. Most people with cerebral palsy have spastic paralysis.

Or it can be floppy, or flaccid, when your muscles sag and eventually shrink. Polio was once a common cause of flaccid paralysis.

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Causes of Paralysis

Paralysis is most often caused by strokes, usually from a blocked artery in your neck or brain. It also can be caused by damage to your brain or spinal cord, the kind that can happen in a car accident, fall, or sports injury, or as a result of a gunshot wound.

Some people are paralyzed by a condition present at birth, such as spina bifida. Brain injuries before, during, or shortly after birth can lead to the movement disorder known as cerebral palsy. 

Some kinds of paralysis are caused by health conditions or diseases, including those linked to specific genes:

Demyelinating diseases. These happen when the protective coating around your nerve cells, called the myelin sheath, is damaged over time. That makes it harder for your neurons to send signals throughout your body. It weakens your muscles and eventually causes paralysis. There are several demyelinating diseases, but the most common is multiple sclerosis.

Motor neuron diseases (MNDs). Motor neurons are the nerve cells that control the muscles you use to walk, breathe, speak, and move your limbs. There are two types: upper motor neurons, which send signals from your brain down to your spinal cord; and lower motor neurons, which get those signals and send them to your muscles. MNDs are diseases that damage these cells over time.

  • Upper motor neuron diseases, such as primary lateral sclerosis (PLS), affect just the upper motor neurons. This makes muscles stiff and spastic.
  • Lower motor neuron diseases,such as spinal muscular atrophy (SMA), affect only the lower motor neurons. This makes muscles floppy or flaccid, which makes them weak and sometimes causes them to twitch uncontrollably.
  • The most common MND is amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), which affects both upper and lower neurons.

Periodic paralysis. This is caused by genetic differences some people inherit. It involves seemingly random attacks of paralysis. Depending on the type, the attacks can be triggered by low or high potassium levels in the blood, exercise, stress, colds, high carbohydrate meals, fasting, certain medicines, or high thyroid hormone levels.

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Sleep paralysis. This happens while you’re waking up or falling asleep. Sometimes, people who have sleep paralysis will also see things that aren’t there (hallucinations).

Bell’s palsy. This makes one side of your face appear to droop. Doctors think it’s caused by certain viruses, including the herpes viruses that cause cold sores, chicken pox, and shingles. 

Todd’s paralysis. This often happens for a brief period after a person with epilepsy has had a seizure, usually just on one side of their body.

Tick paralysis and Lyme disease . Some ticks have neurotoxins in their spit glands that can cause paralysis, starting in your feet and legs and moving upward. Once the tick is removed, the paralysis goes away, but if it’s not treated, it can spread to your face and be very serious. Ticks sometimes also cause Lyme disease, a bacterial infection that can cause several different symptoms, including facial paralysis and numbness in your arms and legs.

Human T - cell leukemia virus type 1 (HTLV-1)- associated myelopathy. Also called tropical spastic paraparesis (TSP), this type of spastic paralysis comes on gradually after an infection with HTLV-1. It causes symptoms that are similar to MS, but it happens in less than 3% of people infected with the virus.

Acute flaccid myelitis (AFM). In some countries, this is called acute flaccid paralysis (AFP). It's a polio-like illness likely caused by viruses. It occurs mostly in children. The most common symptom is sudden weakness in an arm or leg. In severe cases, it can affect swallowing, speech, and breathing.

Paralysis Symptoms

If you have paralysis, you are partly or completely unable to move the affected parts of your body. You might also lose some or all the feeling in those parts. This happens suddenly with strokes and spinal cord injuries.

But in some cases, symptoms can develop more gradually. You might experience:

  • A steady loss of feeling
  • Trouble moving parts of your face or body
  • Weakness or floppiness
  • Muscle cramps
  • Numbness or tingling
  • Stiffness

You should call 911 if you or someone else has sudden signs of paralysis after an injury to the head, neck, or back, or shows the following symptoms:

  • Trouble speaking, breathing, or swallowing
  • Loss of feeling or movement on one side of the face or one arm
  • Tingling and a loss of feeling anywhere in the face or body

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Paralysis Diagnosis

To understand what's causing your problem, your doctor will examine you and ask about any recent injuries. If your symptoms came on gradually, they'll ask when you first noticed them.

You might get several tests, such as:

  • X-rays to find broken bones that could injure nerves
  • Scans, such as MRIs or CTs, to look for signs of stroke or damage to your brain and spinal cord
  • A myelogram, to get detailed pictures of your spinal cord, using a special dye injected in the spinal column
  • An EMG (electromyogram), a test of the electrical activity in your nerves and muscles
  • A spinal tap (lumbar puncture), a test in which some cerebrospinal fluid is taken from your spine and tested for infection, inflammation, and signs of certain diseases

Paralysis Complications

Depending on the type of paralysis you have and its location, you might develop complications such as:

  • Trouble breathing
  • An increased risk for pneumonia
  • Blood clots
  • Speech problems
  • Swallowing problems
  • Depression
  • Anxiety
  • Trouble getting and keeping an erection
  • Other sexual functioning problems
  • Very high or low blood pressure
  • Trouble controlling when you pee or poop
  • Pressure sores (bed sores)
  • Blood infections

Some of these complications can be life-threatening if not managed well. Others can reduce your quality of life. Medical professionals can help. For example, in some cases, adjusting your medications might help with urine leaks. Watching for skin changes and learning to adjust your positions can help prevent pressure sores or keep them from getting worse. If you're depressed, you can talk to your doctor about treatment. Support organizations for people living with paralysis also can connect you with others facing similar challenges.

Paralysis Treatment

There's no cure for permanent paralysis. If your spinal cord is injured, it can't repair itself. Temporary paralysis may go away without treatment, though there are helpful treatments for some types. For example, people with Bell's palsy may get steroids and antiviral drugs.

Some therapies can improve the lives of people with all sorts of permanent paralysis, including those caused by spinal cord injuries and strokes. These include:

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Rehabilitation. After a spinal cord injury or disabling stroke, you likely will go to a center that specializes in helping you recover as much as possible and live with new challenges. Doctors, nurses, mental health professionals, occupational therapists, and physical therapists may be involved in your care. Treatment typically includes exercise and education on how to do everyday things such as getting in and out of bed, bathing, and eating, depending on your needs.

Functional Electrical Stimulation. Devices that deliver small electrical pulses to paralyzed muscles can be used to restore some limited functioning. For example, someone who otherwise has no use of their legs might be able to ride an exercise bike. The devices have also been used to improve bladder function and assist with breathing, standing, and walking.

People with paralysis caused by medical conditions such as multiple sclerosis and ALS may get help from medicines that slow the progression of their conditions.

In addition, people with movement challenges often benefit from adaptive tools and devices that help with everyday activities ranging from getting around your home and community to brushing your teeth. So, they might include things such as braces, splints, wheelchairs, and walkers, as well as gadgets for cooking, grooming, and handling household chores.

Takeaways

Paralysis can have many causes, be permanent or temporary, and affect small or large parts of your body. Strokes, injuries, and infections are among the most common causes. While there's no cure for permanent paralysis, there are therapies and devices that can help you cope.

WebMD Medical Reference

Sources

SOURCES:

ALS Association: “Ask the Doc: Q & A with Edward Kasarskis, MD, PhD.”

American Academy of Sleep Medicine: “Sleep Paralysis -- Overview & Facts.”

American Lyme Disease Foundation Inc.: “Lyme Disease,” “Tick Paralysis.”

Christopher & Dana Reeve Foundation: “Causes of Paralysis,” “Cerebral Palsy,” “Multiple Sclerosis,” “Muscular Dystrophy,” “Spinal Muscular Atrophy.”

Cleveland Clinic: “Paralysis.”

Encyclopedia Britannica: “Hemiplegia.”

Genetic and Rare Diseases Information Center: “HTLV-1 associated myelopathy/tropical spastic paraparesis.”

Mayo Clinic: “Bell’s Palsy,” “Demyelinating disease: What can you do about it?” “Muscular Dystrophy,” “Spinal Cord Injury.”

MedlinePlus: “Paralysis.”

Merriam-Webster Medical Dictionary: “Diplegia,” “Hemiplegia,” “Monoplegia.”

National Health Service (UK): “Brain Tumours,” “Muscular Dystrophy.”

National Institute of Neurological Disorders and Stroke: “Familial Periodic Paralyses Information Page,” “Motor Neuron Diseases Fact Sheet,” “Post-Stroke Rehabilitation,” “Todd’s Paralysis Information Page.”

National Multiple Sclerosis Society: “HTLV-1 Associated Myelopathy (HAM).”

National Organization for Rare Disorders: “Locked In Syndrome.”

Pediatric Brain Foundation: “Cerebral Palsy (CP).”

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