Paralysis

What is paralysis?

Paralysis occurs when you’re unable to make voluntary muscle movements. A nervous system problem causes paralysis. Nerves send signals to your muscles. Those signals make your muscles move. When you’re paralyzed, or have paralysis, you can’t move certain parts of your body.

Paralysis can affect any part of your body. It can be:

• Partial (paresis): You can control some muscles, but not all.
• Complete: You have no control over any muscles.

Paralysis can also be broken down into two types based on the site of injury in your nervous system:

• Flaccid: Your muscles get weak and very loose.
• Spastic: Your muscles tighten, with involuntary jerks and spasms (spasticity).

How common is paralysis?

Approximately 1 in 50 Americans, or 5.4 million people, have some form of paralysis.

Some people experience temporary paralysis and regain partial or full movement over time. For example, Bell’s palsy typically temporarily paralyzes your facial muscles. Palsy is the name for paralysis accompanied by tremors.

Permanent paralysis means you never regain muscle control. The condition is irreversible (can’t be reversed).

What are the types of paralysis?

Localized paralysis affects a small section of your body. It most commonly affects your face, hands, feet or vocal cords.

Generalized paralysis affects a larger area. Healthcare providers categorize generalized paralysis based on the extent of paralysis. The different types of paralysis include:

• Diplegia: Paralysis occurs on the same area on both sides of your body. For example, paralysis affects both arms, both legs or both sides of your face.
• Hemiplegia: Paralysis affects one side of your body (an arm and a leg on the same side).
• Monoplegia: You can’t move one limb (arm or leg).
• Paraplegia: Paralysis affects both legs and sometimes your torso.
• Quadriplegia (tetraplegia): Paralysis involves all limbs and the torso. People with quadriplegia may have little or no movement from the neck down.

What are the symptoms of paralysis?

If you have paralysis, you’re partly or entirely unable to move the affected parts of your body. Paralysis may be accompanied by a loss of sensation depending on the location of the injury.

Paralysis can be present at birth, for example with cerebral palsy.

Strokes and spinal cord injuries cause sudden paralysis.

Some medical conditions can cause gradual paralysis. You may experience the following paralysis symptoms:

• A steady loss of feeling and muscle control.
• Muscle cramps.
• Tingling or numbness in your limbs.

What causes paralysis?

A problem with your nervous system causes paralysis. Your nervous system is your body’s command and communication system. It sends signals from your brain throughout your body, telling it what to do. If something damages your nervous system, messages can’t get through to your muscles.

Most often, a traumatic injury or medical condition damages muscle and nerve function. Strokes and spinal cord injuries are the most common causes of paralysis. Other causes include:

• Birth defects like spina bifida.
• Autoimmune diseases, including multiple sclerosis (MS) and Guillain-Barré syndrome.
• Brain injuries, including conditions like traumatic brain injury and cerebral palsy.
• Neurological diseases, like amyotrophic lateral sclerosis (ALS).

What are the complications of paralysis?

Paralysis can affect your breathing muscles and heart rate. The condition can also involve other body systems in the affected area. Depending on the type of paralysis, you may be at risk for:

• Difficulty breathing, coughing and pneumonia.
• Blood clots and deep vein thrombosis (DVT).
• Speech or swallowing problems (dysphagia).
• Depression and anxiety.
• Erectile dysfunction and sexual issues.
• Excessively high blood pressure (autonomic dysreflexia) or low blood pressure (orthostatic hypotension) and heart problems.
• Urinary incontinence and loss of bowel control.
• Pressure injuries (bedsores) and sepsis.

How is paralysis diagnosed?

A healthcare provider will examine you and ask about any injuries. For gradual paralysis, you’ll talk about when you began noticing the problem. To learn more, your healthcare provider may order one or more tests:

• X-rays show broken bones that could cause nerve injury.
• Imaging tests, like a CT scan or an MRI, check for signs of stroke, brain injury or spinal cord injury. A whole-body imaging scan shows bones, muscles and tissues.
• Myelogram checks for spinal cord and nerve injuries.
• Electromyogram (EMG) tests the electrical activity of nerves and muscles.
• Spinal tap (lumbar puncture) tests spinal fluid for infection, inflammation and disorders like multiple sclerosis (MS).

Can you recover from paralysis?

There isn’t a cure for permanent paralysis. Temporary paralysis like Bell’s palsy often goes away over time without treatment. In some cases, there may be some improvement, particularly during the first year.

How is paralysis managed or treated?

Paralysis treatment usually includes physical, occupational and speech therapy. These can accommodate paralysis and provide exercises, and adaptive and assistive devices to help improve function. These rehabilitation services can help people with all types of paralysis live independently and enjoy a better quality of life.

Other care depends on the cause of paralysis and how it affects you. Your healthcare provider may recommend rehabilitation along with:

• Adaptive equipment that allows you to feed yourself or drive.
• Assistive equipment, like wheelchairs, scooters, crutches and canes.
• Orthotic/prosthetic devices, like braces.
• Voice-activated technology for computers, lighting systems and phones.
• Treatment for complications of paralysis, like spasticity and urinary problems.

How do you prevent paralysis?

Spinal injuries are a leading cause of paralysis. You can lower your chances of spinal injury by taking these steps:

• Always wear a seatbelt. Make sure children are using car seats or booster seats correctly.
• Check water depths before diving.
• Don’t drive while under the influence or ride with an impaired driver.
• Use precautions when participating in sports or activities. For example, wear a helmet when playing sports or riding your bike. Have a spotter in gymnastics and use cushioning mats when appropriate.
• Never move someone who may have a head, neck or spine injury. Call 911 or emergency services.

What is the prognosis (outlook) for people who have paralysis?

Learning to live with paralysis is challenging. It can cause dramatic changes to your life, activities and self-image. These changes can result in mental health issues and depression. Talk with your healthcare provider about getting physical and emotional support.

Over time, and with rehabilitation, many people with paralysis learn to adapt. Many people lead independent, active lives with paralysis. People with quadriplegia often need lifelong help from others, but their minds can stay active.

Maintaining a healthy lifestyle is very important to decrease the risk of complications from paralysis. Keeping an exercise routine is generally recommended, choosing exercises that are consistent with one’s abilities.

When should I see my healthcare provider?

You should call 911 if you have signs of stroke or if someone has a possible head, neck or spine injury. Other reasons to get immediate medical help include:

• Difficulty breathing, swallowing or speaking.
• Numbness or tingling in your arms or legs.
• Muscle weakness that may persist or come and go.
• Sudden inability to move your muscles.

What questions should I ask my healthcare provider?

You may want to ask your healthcare provider:

• Is the paralysis temporary or permanent?
• Will I regain any movement? If so, how long will that take?
• What is the best treatment for me?
• What mobility or assistive devices can help?
• Should I look out for signs of complications?