Paralysis (Weakness of Limbs)

Paralysis means loss of strength or movement in a part of the body. It can affect one side of the body, both legs, all four limbs or a single limb. It may be partial weakness or complete loss of movement, and it can come on suddenly or develop slowly, depending on the cause.

Symptoms

• Weakness or heaviness of an arm, a leg or one side of the body
• Drooping of one side of the face
• Difficulty walking, frequent falls or dragging of a foot
• Numbness or loss of feeling
• Slurred speech or difficulty understanding speech
• Stiffness or spasms in the limbs
• Loss of bladder or bowel control, particularly when the spinal cord is affected

Causes

Weakness of one side of the body is most often caused by a problem in the brain, while weakness of both legs or all four limbs often points to the spinal cord. Common causes include:

• Stroke, due to a blocked blood vessel or bleeding in the brain
• Head injury or spinal injury
• Brain tumour or spinal tumour
• Pressure on the spinal cord from a slipped disc, narrowing of the spinal canal or spinal tuberculosis
• Infections such as a brain abscess or spinal infection
• Nerve conditions such as Guillain-Barre syndrome
• Bell's palsy, which affects only the face
• Rarely, low potassium or other chemical imbalances in the blood

Diagnosis

Sudden weakness needs immediate assessment. The doctor examines strength, sensation, reflexes and the pattern of weakness to locate the problem. An urgent CT or MRI scan of the brain is done for one-sided weakness, and an MRI of the spine for weakness of the legs or all four limbs. Blood tests, nerve conduction studies and other tests may be needed depending on the findings.

Treatment

Treatment depends on the cause found on examination and scans. For a stroke caused by a blocked artery, clot-dissolving treatment or clot-removal procedures can help, but only within a few hours of the start of symptoms, which is why reaching hospital quickly matters so much. Many strokes are managed with medicines, control of blood pressure, sugar and cholesterol, and rehabilitation.

Surgery is needed when there is pressure on the brain or spinal cord, for example from a large brain bleed, a blood clot after injury, a tumour, an abscess, a slipped disc or spinal tuberculosis. Timely decompression in such cases gives the nerves a better chance to recover. Physiotherapy, occupational therapy and speech therapy are important parts of recovery for most patients, and improvement can continue for many months.

When to Seek Urgent Care

• Sudden weakness or numbness of the face, arm or leg, especially on one side
• Sudden difficulty speaking or understanding
• Sudden loss of vision, severe headache or loss of balance
• Weakness after a head, neck or back injury
• Weakness of both legs with loss of bladder or bowel control
• Weakness that is getting worse over hours or days

Remember the warning signs of stroke: Face drooping, Arm weakness, Speech difficulty, Time to act. Note the time symptoms began and go to the nearest emergency immediately.

If you or a family member has weakness of the limbs or one side of the body, consult Dr. Prashant Sharma for a careful evaluation and treatment plan.

Related Conditions

• Unconsciousness (Loss of Consciousness)
• Vertigo
• Head Injury
• Blood Clot in the Brain
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