Paralysis

What is paralysis?

Paralysis occurs when you’re unable to make voluntary muscle movements. A nervous system problem causes paralysis.

Uninjured nerves send signals to muscles. Those signals make muscles move. When you’re paralyzed, or have paralysis, you can’t move certain parts of your body.

How common is paralysis?

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

What are the degrees of severity of paralysis?

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

Permanent paralysis means you never regain muscle control. The condition is irreversible.

Paralysis can affect any part of the 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 the nervous system:

• Flaccid: Your muscles get flabby and shrink.
• Spastic: The muscles tighten, causing uncontrollable jerks and spasms (spasticity).

What are the patterns of muscle paralysis?

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

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

• Diplegia: Paralysis occurs on the same area on both sides of the body. For example, paralysis affects both arms, both legs or both sides of the face.
• Hemiplegia: Paralysis affects one side of the 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 the torso.
• Quadriplegia (Tetraplegia): Paralysis involves all limbs. People with quadriplegia may have little or no movement from the neck down.

What causes paralysis?

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

Some people are born with birth defects like spina bifida that cause paralysis. More often, a traumatic injury or medical condition damages muscle and nerve function.

Strokes and spinal cord injuries are the top causes of paralysis. Other causes include:

• Autoimmune diseases, including multiple sclerosis (MS) and Guillain-Barré syndrome.
• Brain injuries, including conditions like cerebral palsy.
• Neurological diseases, such as amyotrophic lateral sclerosis (ALS).

What are the symptoms of paralysis?

If you have paralysis, you are partly or entirely unable to move the affected parts of the body. Paralysis may be accompanied by a loss of sensation depending on the location of the injury. Strokes and spinal cord injuries cause sudden paralysis.

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

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

How is paralysis diagnosed?

Your 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 of these tests:

• X-rays show broken bones that could cause nerve injury.
• Imaging tests, such as a CT scan or MRI, check for signs of stroke or 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).

What are the complications of paralysis?

Paralysis can affect other bodily functions like breathing 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 risk for pneumonia.
• Blood clots and deep vein thrombosis (DVT).
• Speech or swallowing problems (dysphagia).
• Depression and anxiety.
• Erectile dysfunction and sexual problems.
• 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 managed or treated?

There isn’t a cure for permanent paralysis. The spinal cord can’t heal itself. Temporary paralysis like Bell’s palsy often goes away over time without treatment.

Physical, occupational and speech therapy can accommodate paralysis and provide exercises, adaptive and assistive devices to 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, such as wheelchairs, scooters, crutches and canes.
• Orthotic/prosthetic devices, such as braces.
• Voice-activated technology for computers, lighting systems and phones.

How can I 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. 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.

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 need lifelong help from others, but their minds can stay active.

When should I call the doctor?

You should call 911 if you have signs of stroke or if someone has a possible head, neck or spine injury. Otherwise, call your healthcare provider if you experience:

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

What questions should I ask my doctor?

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?

A note from Cleveland Clinic

Paralysis is a life-changing condition. Even temporary paralysis can affect your ability to do the things you love. If paralysis occurs suddenly, it can be challenging to adjust to major changes to your way of life. Your healthcare provider can guide you as you choose among the many available rehabilitation and mental health services. Many people with paralysis enjoy active lives with mobility devices and the support of loved ones.