Lower extremity central paralysis

Introduction Central paralysis of the lower extremities is a 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.

Cause

Etiology: Common causes are intracranial hemorrhage after birth trauma and suppurative, tuberculous or other types of meningitis in neonates or infancy. In addition, there are also congenital malformations and tumors. The symptoms are repeated vomiting. Brain degeneration, brain development disorders, central limb spasm, especially lower limbs, often have intellectual changes and developmental disorders. The optic nerve is atrophied and can cause blindness. Eyeball tremors, convulsions are also more common.

an examination

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Diagnosis: Congenital hydrocephalus in infants and young children begins to increase in the first few weeks after birth. It is usually found after 3 to 5 months, and the head is enlarged at birth. Clinically, the abnormal increase of the head caused by the increase of intracranial pressure is not proportional to the development of the whole body. The forehead protrudes forward, the dome is pressed downward, the eyeball is lowered downward, the eyeball is turned downward, the upper part of the sclera is white, the anterior ankle is enlarged and the tension is increased, other sacs can be enlarged, the skull joint is separated, and the scalp vein is dilated. The head of the percussion is "breaking pot sound."

Infants and young children with patent sutures, when the intracranial pressure is increased, the skull can be compensated for expansion, so the symptoms of increased intracranial pressure in early stage may not be obvious. However, if the hydrocephalus is serious and the progress is rapid, it may also appear. The symptom is repeated vomiting. Brain degeneration, brain development disorders, central limb spasm, especially lower limbs, often have intellectual changes and developmental disorders. The optic nerve is atrophied and can cause blindness. Eyeball tremors, convulsions are also more common. Also often complicated with other parts of the body deformed.

In a few cases, hydrocephalus can stop itself after a certain period of development, the head does not continue to increase, and the intracranial pressure is not high, becoming a "stationary hydrocephalus."

Differential diagnosis

Differential diagnosis of central iliac crest:

1, lower limb weakness: lower limb weakness is caused by cervical spondylotic myelopathy, manifested as lower limb weakness, numbness, tightness, heavy lifting and other symptoms, gradually appearing limp, trembling, gait shaking, easy to fall, etc. . Cervical spondylotic myelopathy is a type of cervical spondylosis. Cervical spondylosis can be roughly divided into four types: cervical cervical spondylosis, radiculous cervical spondylosis, vertebral artery type cervical spondylosis, and cervical spondylotic myelopathy. Cervical spondylosis, also known as cervical vertebra syndrome, is a general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, and cervical disc herniation. It is a disease based on degenerative pathological changes. Mainly due to long-term cervical vertebrae strain, bone hyperplasia, or disc herniation, ligament thickening, resulting in cervical spinal cord, nerve root or vertebral artery compression, a series of clinical syndromes of dysfunction. The manifestations of cervical disc degeneration and its secondary pathological changes, such as vertebral instability, loosening; nucleus protruding or prolapse; spur formation; ligament hypertrophy and secondary spinal stenosis, etc., stimulated or oppressed Adjacent nerve roots, spinal cord, vertebral artery, and cervical sympathetic nerves, and cause a variety of symptoms and signs of the syndrome.

2, lower limb swelling and fatigue: lower limb swelling and fatigue is one of the symptoms of deep vein thrombosis.

3, lower limbs or soft body of the whole body: lower limbs or soft palate in the whole body is a symptom of the water and salt metabolism disorder in Barth Syndrome.

4, sudden lower limbs sputum: sputum refers to the loss or disappearance of random movements, sudden paralysis of both lower limbs is a kind of sputum.

5. Muscle spasm below the thigh or below the knee: Diagnosis of sciatic nerve injury: history of trauma or history of injection, muscle spasm below the thigh or below the knee; muscle spasm in the branch of the nerve branch. The area below the calf is partially lost. Electromyography can confirm the diagnosis.

6, amyotrophic lateral sclerosis: a degenerative disease. The lesion mainly involves the spinal cord anterior horn cells, the medullary motor nucleus and the pyramidal tract. Therefore, the main obstacles are dyskinesia, and there is generally no sensory disturbance. There may be root pain in the early stage, which is characterized by atrophy of the upper limb hand muscles and atrophy of the tongue muscle. In severe cases, there is difficulty in constructing sound. When the motor neurons above the lesion are predominant, the tendon reflex is hyperthyroidism. There was no obstruction in the spinal cord, and the cerebrospinal fluid was normal and biochemical examination was normal.

7, lower extremity muscle spasm: lower extremity muscle spasm is a symptom of spinal cord compression.

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