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Paraplegia

Paraplegia. Dr. Shamekh M. El- Shamy. Paraplegia. Definition: Paraplegia is paralysis or weakness ( paraparesis ) of both lower limbs. It may be due to:. Spinal paraplegia may be: 1. Focal 2. Systemic 3. Disseminated paraplegia. Causes of Spinal Paraplegia.

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Paraplegia

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  1. Paraplegia Dr. Shamekh M. El-Shamy

  2. Paraplegia Definition: Paraplegia is paralysis or weakness (paraparesis) of both lower limbs. It may be due to:

  3. Spinal paraplegia may be: 1. Focal 2. Systemic 3. Disseminated paraplegia

  4. Causes of Spinal Paraplegia I-Focal Causes : A- Compression:

  5. Neoplastic diseases:

  6. 2- Meningeal (extramedullary): 3- Cord (intramedullary): -

  7. B- Inflammatory: C- Vascular : II-SYSTEMIC CAUSES:

  8. III-DISSEMINATED CAUSES:

  9. CEREBRAL PARAPLEGIA A- Causes in the Parasagittal Region: (area of cortical presentation of L.L.) B- Causes in the brain Stem :

  10. CLINICAL PICTURE OF FOCAL PARAPLEGIA A. AT THE LEVEL OF THE LESION:

  11. a)Posterior root affection: b)Anterior root affection:

  12. B.BELOW THE LEVEL OF THE LESION (cord manifestations): 1- Motor Manifestations:

  13. (paraplegia in extension) (paraplegia in flexion).

  14. 2- Sensory Manifestations a) If the cause of the lesion is extramedullary,

  15. b) If the cause of the lesion is intramedullary,

  16. Sensory level below which all sens. are lost Extramedullary copression Intramedullary Jacket sensoryy loss

  17. 3- Sphincteric Manifestations a) In acute lesions: b)In gradual lesions:

  18. Investigations 1) C.S.F. Examination. 2)Plain X-Ray of the Spine. 3) Myelography.

  19. Treatment of Paraplegia I- General: - Care of the skin. - Care of the bladder.

  20. II- Physiotherapy

  21. III- Symptomatic Treatment a) Analgesics and sedatives for pain. b) Muscle relaxants : Valium for the spasticity. c)Vitamins and tonics.

  22. IV- Specific Treatment Antituberculous drugs in case of Pott's disease. Deep X-ray in case of intra-medullarytumour. Surgical eradication in case of extra-medullarytumour.

  23. CaudaEquina Epiconus Conus Roots Cadua Equina

  24. CAUSES OF CAUDA EQUINA LESIONS 1- Congenital: Spinal bifida. 2-Traumatic: 3-Inflammatory: Pott's disease of the lumbar vertebrae. 4- Neoplastic: 5. Degenerative: Lumbar Spondylosis.

  25. Neurogenic Bladder IU.M.N.L. 1. Acute : Retention with overflow 2. Gradual:a- Partial: Precipitancy b-Complete:Automatic bladder II L.M.N.L. 1.Sensory atonic bladder 2.Motor atonic bladder 3.Autonomic bladder

  26. Thank you

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