4/07/2010

Loss of movement; Motor dysfunction




REFERENCE FROM 

A.D.A.M.

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Alternative Names
Paralysis; Paresis; Loss of movement; Motor dysfunction
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Considerations
Loss of muscle function may be caused by:
Injury such as a broken neck or back
Nerve damage (neuropathy)
Not using a muscle
Stroke or other brain injury
The loss of muscle function after these types of events can be severe, and often will not completely return.
Paralysis can be temporary or permanent. It can affect a small area (localized) or be widespread (generalized). It may affect one side (unilateral) or both sides (bilateral).
If the paralysis affects the lower half of the body and both legs it is called paraplegia. It if affects both arms and legs, it is called quadriplegia. If the paralysis affects the muscles that cause breathing, it is quickly life threatening.
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Causes
Causes of paralysis include:
Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease)
Neuropathy
Paralytic shellfish poisoning
Periodic paralysis
Peroneal dystrophy
Stroke
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Home Care
Sudden loss of muscle function is a medical emergency. Seek immediate medical help.
After you have received medical treatment, your doctor may recommend some of the following measures:
Follow your prescribed therapy.
If the nerves to your face or head are damaged, you may have difficulty chewing and swallowing or closing your eyes. In these cases, a soft diet may be recommended. You will also need some form of eye protection, such as a patch over the eye while you are asleep.
Long-term immobility can cause serious complications. Change positions often and take care of your skin. Range-of-motion exercises may help to maintain some muscle tone.
Splints may help prevent muscle contractures, a condition in which a muscle becomes permanently shortened.

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When to Contact a Medical Professional
Muscle paralysis always requires immediate medical attention. If you notice gradual weakening or problems with a muscle, get medical attention as soon as possible.
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What to Expect at Your Office Visit
The doctor will perform a physical examination and ask questions about your medical history and symptoms, including:
Location
What part(s) of the body are affected?
Does it affect one or both sides of the body?
D it develop in a top-to-bottom pattern (descending paralysis), or a bottom-to-top pattern (ascending paralysis)?
Do you have difficulty getting out of a chair or climbing stairs?
Do you have difficulty lifting your arm above your head?
Do you have problems extending or lifting your wrist (wrist drop)?
Do you have difficulty gripping (grasping)?
Symptoms
Do you have pain?
Do you have numbnesstingling, or loss of sensation?
What other symptoms do you have?
Time pattern
Do episodes occur repeatedly (recurrent)?
How long do they last?
Is the muscle function loss getting worse (progressive)?
Is it progressing slowly or quickly?
Does it become worse over the course of the day?
Aggravating and relieving factors
What, if anything, makes the paralysis worse?
Does it get worse after you take potassium supplements by mouth?
Is it better after you rest?
Tests that may be performed include:
Blood studies (such as CBCblood differential, or blood chemistry levels)
Nerve conduction studies and electromyography
Intravenous feeding or feeding tubes may be required in severe cases. Physical therapy, occupational therapy, or speech therapy may be recommended.
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References
Griggs RC, Józefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa. Saunders Elsevier; 2007: chap 418.
Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa. Saunders Elsevier; 2007: chap 447.



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