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Paraplegia. Dr. Shamekh M. El- Shamy. Paraplegia. Definition: Paraplegia is paralysis or weakness ( paraparesis ) of both lower limbs. It may be due to:. Spinal paraplegia may be: 1. Focal 2. Systemic 3. Disseminated paraplegia. Causes of Spinal Paraplegia.
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Paraplegia Dr. Shamekh M. El-Shamy
Paraplegia Definition: Paraplegia is paralysis or weakness (paraparesis) of both lower limbs. It may be due to:
Spinal paraplegia may be: 1. Focal 2. Systemic 3. Disseminated paraplegia
Causes of Spinal Paraplegia I-Focal Causes : A- Compression:
2- Meningeal (extramedullary): 3- Cord (intramedullary): -
B- Inflammatory: C- Vascular : II-SYSTEMIC CAUSES:
CEREBRAL PARAPLEGIA A- Causes in the Parasagittal Region: (area of cortical presentation of L.L.) B- Causes in the brain Stem :
CLINICAL PICTURE OF FOCAL PARAPLEGIA A. AT THE LEVEL OF THE LESION:
a)Posterior root affection: b)Anterior root affection:
B.BELOW THE LEVEL OF THE LESION (cord manifestations): 1- Motor Manifestations:
(paraplegia in extension) (paraplegia in flexion).
2- Sensory Manifestations a) If the cause of the lesion is extramedullary,
Sensory level below which all sens. are lost Extramedullary copression Intramedullary Jacket sensoryy loss
3- Sphincteric Manifestations a) In acute lesions: b)In gradual lesions:
Investigations 1) C.S.F. Examination. 2)Plain X-Ray of the Spine. 3) Myelography.
Treatment of Paraplegia I- General: - Care of the skin. - Care of the bladder.
III- Symptomatic Treatment a) Analgesics and sedatives for pain. b) Muscle relaxants : Valium for the spasticity. c)Vitamins and tonics.
IV- Specific Treatment Antituberculous drugs in case of Pott's disease. Deep X-ray in case of intra-medullarytumour. Surgical eradication in case of extra-medullarytumour.
CaudaEquina Epiconus Conus Roots Cadua Equina
CAUSES OF CAUDA EQUINA LESIONS 1- Congenital: Spinal bifida. 2-Traumatic: 3-Inflammatory: Pott's disease of the lumbar vertebrae. 4- Neoplastic: 5. Degenerative: Lumbar Spondylosis.
Neurogenic Bladder IU.M.N.L. 1. Acute : Retention with overflow 2. Gradual:a- Partial: Precipitancy b-Complete:Automatic bladder II L.M.N.L. 1.Sensory atonic bladder 2.Motor atonic bladder 3.Autonomic bladder