Syndrome of sluggish paralysis

Description:

It is a neurologic syndrome which develops at defeat of peripheral neuron, and characterized by loss both any, and involuntary, or reflex, innervations.

Symptoms of the Syndrome of sluggish paralysis:

indry sluggish paralysis it is characterized by the following signs [Duus P., 1995]:
- absence or decrease in an animal force;
- decrease in a muscle tone;
- hyporeflexia or areflexia;
- hypotrophy or atrophy of a muscle.

Hypotonias and areflexias develop in connection with interruption of an arch of a monosinaptichesky reflex on stretching and frustration of the mechanism of tonic and phasic reflexes on stretching. The atrophy a muscle is caused by disturbance of trophic influence from a front horn on muscle fibers, develops several weeks later after denervation of muscle fibers and can be so expressed that in several months or years in a muscle there is safe only a connecting fabric.

Reasons of the Syndrome of sluggish paralysis:

Sluggish paralysis (paresis) develops at defeat of peripheral  (lower) neuron on any site: front horn, root, texture, peripheral nerve.

Treatment of the Syndrome of sluggish paralysis:

Recovery actions at development of sluggish paresis or paralysis are directed, first, to recovery (whenever possible) to function of peripheral neuron, secondly, on the prevention of development of an atrophy of muscular tissue and prevention of contractures.

Improvement of function of nervous tissue is reached by purpose of neytrotrofny and vasoactive drugs:

    * nootropil/piracetam (in capsules/tablets on 0,4 g-0.8 of three times a day or 20% solution on 5-10 ml intramusculary or intravenously);
    * Cerebrolysinum (on 3-5 ml intramusculary or intravenously);
    * Actovegin (on 5-10 ml intramusculary or intravenously kapelno one or two times a day; 1 ml contains 40 mg of active agent);
    * trental (in a dragee, on 0,1 g three times a day, or intravenously kapelno on 5 ml once a day; 1 ml contains 0,02 g of active agent);
    * B1 vitamin (solution of Thiamini chloridum of 2,5% or 5% or Thiamini bromidum of 3% or 6% on 1 ml intramusculary daily 1 time a day);
    * B12 vitamin (on 400 mkg of 1 times in 2 days intramusculary, it is possible along with vitamin B 1, but not in one syringe).

At disturbance of anatomic integrity of peripheral nerves neurosurgical intervention can be shown.

Prevention of development of an atrophy of muscles. Is very important task as the degeneration of denervated muscle fibers develops very quickly and often has irreversible character. By the time of recovery of an innervation (by natural reinnervation or by means of neurosurgical intervention) the atrophy can reach so expressed degree that function of a muscle does not manage to be recovered any more. Therefore actions for prevention of development of an atrophy of muscles with the broken innervation should be begun as soon as possible. For this purpose appoint massage (classical, dot, segmented), remedial gymnastics, electrostimulation of nerves and muscles.

Massage. It is directed to stimulation of muscles therefore among receptions use rather intensive grinding, deep puddling, impact on segmented zones. However at the same time massage of paretichny muscles should not be made with a big force. Massage has to be moderate and incontinuous, but be made within many months (between courses short breaks become). Rough painful receptions can cause increase of weakness of a muscle. Use also acupressure by a tonic technique. The tonic method of acupressure is carried out by drawing by a finger-tip of the vibrating, short, bystry irritations consistently in a row of the points stimulating the necessary movement.