to assess the extent of damage. Prompt interven-
tion is essential for recovery from conditions such
as brain hemorrhage, stroke, BRAIN TUMOR, and
compression of the spinal cord.
Treatment Options and OutlookWhen possible, treatment attempts to remove or
mitigate the source of the paralysis. Such efforts
might include surgery to remove a tumor or col-
lected BLOOD(as in subdural HEMATOMA) or other
fluid that accumulates within the cranium (HYDRO-
CEPHALY). Rapid treatment can halt and even
reverse the effects of stroke due to cerebral infarc-
tion (blood clot in the brain). Once paralysis
becomes permanent, the emphasis of treatment
shifts to maintaining optimal function of remain-
ing motor abilities and learning methods of
accommodation. PHYSICAL THERAPY and OCCUPA-
TIONAL THERAPYare essential dimensions of such
treatment. Many people who have partial paraly-
sis are able to return to independent living and
often to their jobs and many of their favorite
activities. Mobility aids such as wheelchairs,
crutches, canes or walking sticks, walkers, and
braces improve independence and QUALITY OF LIFE.
Risk Factors and Preventive Measures
The risk factors for paralysis are those of the
underlying causes of damage to the brain and
spinal cord. Traumatic injury is the most signifi-
cant risk factor for people under age 30 years, par-
ticularly young men. Conditions such as stroke,
neurologic disorders, and tumors become more
common causes of paralysis among people age 50
years and older. Preventive measures include seat
belt use, protective headgear for activities such as
bicycling and downhill skiing, and prudent judg-
ment when swimming and diving. Lifestyle
choices such as nutritious EATING HABITS, not smok-
ing, and daily physical activity help reduce the risk
for conditions such as stroke. Other causes of
paralysis, such as CEREBRAL PALSYor ALS, are not
preventable.
See also PARKINSON’S DISEASE; SPINA BIFIDA; SPINAL
CORD INJURY; TRAUMATIC BRAIN INJURY(TBI).
paresthesia The sensation of tingling or burning
in a particular part or region of the body. Pares-
thesia is a symptom of damage, temporary or per-
manent, to a NERVEor group of nerves. The “pins
and needles” feeling in a hand or foot that “falls
asleep” is a common experience of transient, or
temporary, paresthesia that results from compres-
sion of the nerves such as from the limb being
tucked under the body during sleep or when sit-
ting for an extended period without moving.
CARPAL TUNNEL SYNDROMEand ROTATOR CUFF IMPINGE-
MENT SYNDROMEare among the common conditions
that cause compression of the nerves through
swelling and entrapment.
Pathologic paresthesia—parethesia arising from
disease or injury—often occurs with PERIPHERAL
VASCULAR DISEASE(PVD) or NEUROPATHYof DIABETES,
conditions in which impaired BLOODcirculation
causes damage to the PERIPHERAL NERVESof the
hands and feet. Deficiency of B vitamins, espe-
cially B 12 , and HEAVY-METAL POISONING(for example,
arsenic or mercury) affects the myelin sheathing
of nerves and commonly results in paresthesia.
Paresthesia is also a symptom of numerous neuro-
logic disorders and conditions and may occur in
conjunction with NEURALGIA(PAINalong a nerve
tract). Treatment for chronic or persistent pares-
thesia targets the underlying cause and may range
from noninvasive methods such as BIOFEEDBACK
and HYPNOSISto therapeutic interventions such as
medications or surgery.
See also BELL’S PALSY; MULTIPLE SCLEROSIS; SPINAL
CORD INJURY; SYSTEMIC LUPUS ERYTHEMATOSUS(SLE).Parkinson’s disease A degenerative neuromus-
cular disorder that results from the progressive
loss of neurons within the structures of the mid-
brain, notably the substantia nigra, that produce
DOPAMINE, a NEUROTRANSMITTERessential for MUSCLE
function. The loss of muscle function affects both
voluntary (movement) and involuntary (swallow-
ing, digestion, urination) activities.Symptoms and Diagnostic Path
Symptoms become apparent when the number of
dopamine-producing cells drops to about 20 per-
cent of normal and typically include- resting tremor usually affecting the fingers,
hands, feet, and occasionally the MOUTH - bradykinesia (slowed movement)
- stiffness and rigidity of the muscles
Parkinson’s disease 275