Peripheral paralysis of upper extremities

Introduction Peripheral sputum is also called motoneuron sputum, or flaccid paralysis, soft palate. It is caused by the damage of the anterior horn cells of the spinal cord and the brain to the motor nucleus, and the fibers of the anterior root, spinal nerve, and cranial nerves. Peripheral paralysis of the upper extremity refers to the peripheral paralysis of the upper limb in the affected part.

Cause

Common causes of lower motor neuron spasm are: peripheral nerve injury, such as laceration, contusion, compression, brachial plexus trauma, electric shock, radiation injury, burns, etc.; toxic damage, including drugs, organic matter, inorganic matter , bacterial toxins, etc.; peripheral neuritis, including infectious, post-infection and allergic diseases, connective tissue disease and nodular peripheral neuropathy; peripheral neuropathy in metabolic diseases; peripheral neuropathy in malignant diseases; peripheral neurological tumors, Primary and genetic related peripheral neuropathy.

1, single sputum: more common in the middle cerebral artery lesions, such as cerebral hemorrhage, cerebral infarction, cerebral vascular stenosis, brain trauma, brain tumors and other effects on the cortical motor area.

2, hemiplegia: common in cerebral arterial hemorrhage or occlusion, brain tumors, brain abscess, demyelinating disease and glioma. In addition to hemiplegia, there may be partial sensory disturbances and hemianopia.

3, cross-sectional sputum: mostly brain stem lesions, common in brain stem vascular disease, inflammation, tumors, trauma and so on.

4, paraplegia: common in spinal cord infection, tumor, trauma, compression, demyelination and so on.

5, peripheral nerve spasm: common in amyotrophic lateral sclerosis, mononeuritis, polyneuritis, infection, poisoning. Vascular lesions and systemic diseases.

6, muscle lesions and neuromuscular junction lesions caused by sputum: common in myasthenia gravis, polymyositis progressive muscular dystrophy, periodic paralysis.

an examination

Related inspection

Cerebrospinal fluid-bound myelin basic protein sputum test random exercise examination

1, serum potassium decreased, hypokalemia type periodic paralysis; serum potassium increased, up to 5-7mgEq / L, hyperkalemia type periodic paralysis; or normal potassium, normal blood potassium periodicity paralysis.

2, hypokalemia type periodic paralysis, ECG often have hypokalemia changes such as QT interval prolongation, ST segment decline, T wave reduction, U wave is obvious and often with T wave fusion, its low potassium performance often It is earlier than serum potassium. When hyperkalemia type periodic paralysis occurs, the electrocardiogram changes, the T wave is increased at the beginning, the QT interval is prolonged, and the R wave is gradually decreased, the S wave is deepened, the ST segment is decreased, and the PR interval and QRS time are prolonged.

Differential diagnosis

Sudden paralysis of both lower extremities: refers to the loss or disappearance of voluntary movements, and sudden paralysis of both lower extremities is a kind of sputum. Different from the lesion lesions, different types of sputum can be produced clinically, such as sputum, hemiplegia, paraplegia, quadriplegia (sudden paralysis of lower limbs), etc. Although they have different performances, they all have the same characteristics. That is, the muscle tension is increased, the hyperreflexia, the shallow reflex disappears, the so-called joint (joint) movement and pathological reflex appear, the tendon muscle does not shrink, and the electrical test has no denaturing reaction.

Central paralysis of the lower extremities: is the clinical manifestation of congenital hydrocephalus. When the hydrocephalus is severe and the progress is rapid, it may also appear. The symptom is repeated vomiting. Brain degeneration, brain developmental disorders, central limb spasm, especially lower limbs.

Lower motor neuron spasm, also known as peripheral sputum. It is the result of damage to the motor fibers of the anterior horn cells (or cranial nerve motor cells), the anterior spinal cord, the peripheral nerves, and the peripheral nerves of the brain. The motor neuron spasm of the limbs is symmetrical. It is caused by motor neuron disease, which is characterized by the lower motor neuron symmetry of the limbs. Motor neuron disease (MND) is a group of neurodegenerative diseases that are unexplained and selectively damage the anterior horn of the spinal cord and the motor nucleus of the brainstem. The clinical manifestations are the coexistence of upper and lower motor neurons of the limbs, without affecting the sensory system, autonomic nerves, and cerebellar function.

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