Paraparesis: Definition, Causes, Symptoms, Diagnosis and Treatment

It is the diagnosis of a partial paralysis of both legs produced by the nervous signals interrupted from the brain to the muscles.

It is characterized by spasms and progressive muscle weakness in the legs causing difficulty walking.

It can be caused by genetic factors and viral infections.

Causes

Paraparesis is caused by degeneration or damage to nerve pathways. There are two main types of paraparesis, separated according to their cause:

Hereditary Spastic paraparesis:

  • It is related to genetic factors.
  • It causes the long nerves in the spine to degenerate over time.
  • These spinal nerves control muscle tone and movement in the lower part of the body. Damage to these nerves can cause gradual deterioration of movement, usually in both legs.
  • Children of parents with Hereditary Spastic Paraparesia have a 50 percent chance of being diagnosed with this condition.

Tropical Spastic Paraparesis:

  • It is caused by a viral infection.
  • Symptoms may begin long after the original infection, sometimes decades later. Tropical Spastic Paraparesis affects the spinal cord, compromises the immune system and can cause muscle weakness and loss of sensation in both legs.
  • It generally affects people who live in tropical regions, including the Caribbean.
  • It can be transmitted from person to person. You can go from a mother who is breastfeeding her baby, by sharing hypodermic needles and through unprotected sex.
  • Less than 2 percent of people who carry the virus develop paraparesis.

symptom

They can start at any time and at any age. Most people diagnosed with Paraparesia will eventually have difficulty walking and will also see changes in their gait.

While there is currently no cure for paraparesis, the effects it has on the legs can be effectively controlled and minimized. It usually has no impact on life expectancy.

Symptoms of Hereditary Spastic Paraparesis:

People with Hereditary Spastic Paraparesis usually have difficulty walking and have a greater risk of falling. This may be due to exaggerated reflexes, along with spasms, cramps and stiffness.

They also tend to walk on the tip of their toes with their feet turned inward. This way of walking can cause more wear on the shoes, especially around the big toe.

About 90 percent of people with Hereditary Spastic Paraparesis experience leg muscle weakness, as well as involuntary spasms and stiffness.

The remaining 10 percent have a more complex form of Hereditary Spastic Paraparesis with additional symptoms. These may include epilepsy , dementia and hearing loss. They may also experience problems with balance, coordination and speech.

The age of onset of Paraparesis varies greatly, even in members of the same family. Because the symptoms develop gradually, it can be difficult for people to identify exactly when their symptoms first began.

Symptoms of Tropical Spastic Paraparesis:

People who develop Tropical Spastic Paraparesis may experience symptoms for years, even decades, after the initial infection.

Symptoms usually begin with a gradual weakness in the muscles of both legs, followed by urinary and intestinal dysfunction and erectile dysfunction in men.

During the advanced stages of Paraparesis, the arms of a person with this condition may be affected, as well as may develop some problems with their skin.

Diagnosis

Doctors can usually diagnose paraparesis once the following conditions have been met:

  • The affected person has the symptoms of walking and mobility typical of paraparesis.
  • There is a history of paraparesia among members of the immediate family.
  • Other treatable disorders with similar symptoms have been ruled out.

Doctors can also perform other specialized tests during diagnosis, which include:

  • Magnetic resonance images.
  • Scanning of the brain and spine.
  • Lumbar puncture.
  • Tests of nervous conduction.
  • Electromyography

The treatable disorders with symptoms similar to Paraparesis include:

  • Deficiency of vitamin B12.
  • Genetic movement disorder.
  • Structural disorders of the spinal cord.

Doctors should also exclude multiple sclerosis, cerebral palsy, and hereditary motor neuron disease before the diagnosis of paraparesis can be confirmed.

Doctors can sometimes use genetic tests to confirm a clinical diagnosis of this disease when it is hereditary.

Treatment

Currently, there is no cure for Paraparesis. The treatment of the symptoms is the main objective of the treatment. It usually includes physical therapy and medications, such as muscle relaxants.

Physical therapy and exercises can improve mobility by strengthening muscles and increasing endurance. It can also help reduce the severity of spasms and cramps.

In addition to muscle relaxants, some people can take medications to reduce urinary urgency.

Doctors can control the progression of Paraparesis with regular neurological exams.

People diagnosed with paraparesis can expect a normal life expectancy. Up to a quarter of people who have paraparesia do not experience any symptoms.

Symptoms among members of the same family may start at different times, sometimes more than 50 years apart in the age of onset.

Studies suggest that some genetic causes result in a range of severity of symptoms.

Most people diagnosed with Paraparesia walk independently or with very little support. Some people with this condition may benefit from the use of crutches, canes or splints.

Very few people with Paraparesia will require a wheelchair to maintain mobility.