Paraplegia Paraplegia n Definition Paraplegia is paralysis or

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Paraplegia

Paraplegia

Paraplegia n Definition: Paraplegia is paralysis or weakness (paraparesis) of both lower limbs. It

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

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

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

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

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

n Neoplastic diseases:

n Neoplastic diseases:

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

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

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

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

III-DISSEMINATED CAUSES:

III-DISSEMINATED CAUSES:

CEREBRAL PARAPLEGIA A- Causes in the Parasagittal Region: (area of cortical presentation of L.

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

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

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

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

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

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

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

n (paraplegia in extension) n (paraplegia in flexion).

n (paraplegia in extension) n (paraplegia in flexion).

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

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

b) If the cause of the lesion is intramedullary,

b) If the cause of the lesion is intramedullary,

xtramedullary opression amedullary Sensory level below which all sens. are lost Jacket sensoryy loss

xtramedullary opression amedullary Sensory level below which all sens. are lost Jacket sensoryy loss

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

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

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

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

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

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

II- Physiotherapy

II- Physiotherapy

III- Symptomatic Treatment a) Analgesics and sedatives for pain. b) Muscle relaxants : Valium

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

IV- Specific Treatment n Antituberculous drugs in case of Pott's disease. n Deep X-ray

IV- Specific Treatment n Antituberculous drugs in case of Pott's disease. n Deep X-ray in case of intra-medullary tumour. n Surgical eradication in case of extramedullary tumour.

Cauda Equina Epiconus Conus Roots Cadua Equina

Cauda Equina Epiconus Conus Roots Cadua Equina

CAUSES OF CAUDA EQUINA LESIONS 1 - Congenital: Spinal bifida. 2 -Traumatic: 3 -Inflammatory:

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.

Neurogenic Bladder I U. M. N. L. 1. Acute : Retention with overflow 2.

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

Thank you

Thank you

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