Lower motor neuron paralysis

Overview of lower motor neuron paralysis, also known as peripheral paralysis. Is the anterior horn cells (or brain cells Movement), spinal roots, Ridge peripheral nerves around the brain and nerve fiber damage to the campaign results. Etiopathologic disease triggered lower motor neuron paralysis due to the common symptoms are : peripheral nerve injury, such as laceration, contusion, oppression, The brachial plexus injury, electrical injury, radiation injury, burns, etc.; toxic injury, including drugs, organic, inorganic, bacterial toxins; peripheral neuritis, including infection, infection and allergic diseases. nodules of connective tissue disease and peripheral neuropathy; metabolic diseases of peripheral neuropathy; malignant diseases of peripheral neuropathy; peripheral nerve tumors, primary and the genetic and other peripheral neuropathy. Clinical manifestations of lower motor neuron paralysis of the clinical features to reduce muscle tension (so called flaccid paralysis). tendon reflexes weakened or disappeared, muscle atrophy and degeneration -- a reaction test, all lesion was characterized by : 1. anterior horn cells of spinal cord lesions : confined to the anterior horn cells in lesions caused flaccid paralysis without sensory dysfunction, Distribution was paralyzed segmental type, such as spinal cord damage caused front-deltoid muscle atrophy and paralysis. 2. Root lesions : paralysis waves distribution segment type, always root for the same time violations arising radicular pain and segmental type sensory dysfunction. 3. Plexopathy : damage to a limb often caused most of the peripheral nerve paralysis and sensory impairments. 4. Peripheral Neuropathy : paralysis and sensory disturbance and the distribution of each peripheral innervation relations line. Differential diagnosis (1) acute polio (acute poliogmyelitis) have made more rapid onset heat, throat tightness, torpid intake, nausea, vomiting, constipation, diarrhea and other symptoms. Onset usually in the 3 ~ 5 days, heat regressive physical paralysis. Was mostly paralyzed on one leg, also bilateral lower extremity involvement or limbs, was asymmetric flaccid paralysis, muscle tension relaxed. tendon reflexes weakened or disappeared. Feel. Cerebrospinal fluid cell count increased, slightly higher protein content. (2) acute infection Polyneuritis (acute infectious polyneuriti s) also known as acute multiple Yan nerve root or a Grammy Baali (Guillain-Barre) syndrome. Disease before a three-week regular non-specific infection. Presented an acute onset, first leg muscle strength diminishes rapidly move upwards, in a ~ 2 days there tetraplegic. Was flaccid paralysis, tendon reflexes weakened or disappeared. According muscle tenderness. Distal muscular atrophy, no sensory dysfunction. Accompanied cranial nerve damage, to the side or double facial nerve damage styles. Severe cases may have hoarseness, dysphagia, and other palsy symptoms and may have a respiratory muscle paralysis. CSF showed increased protein and cell count to normal or close to normal protein-cell separation. (3) brachial plexus neuritis (brachial plexus nearyitis) acute onset, upper extremity pain of the disease characteristics, first of all in-neck and upper clavicle, after the rapid expansion of the posterior shoulder, arm and hand. intermittent pain started, to the future sustainability. More in a two-week disappearance. Involvement of upper limb muscle strength decline, or reduce tendon reflexes disappear, hands and fingers shallow feeling receded, muscle atrophy was not obvious. Visibility at the check-neural stem a tenderness, its features are : brachial plexus damage mainly on the performance of the arm paralyzed, hands and fingers normal muscle function; Under brachial plexus damage mainly to the distal arm paralyzed, Hand the small muscle atrophy in a "eagle claw hand" of the forearm and hand ulnar sensory and autonomic dysfunction. EMG lose nerve potentials, motor units declined, multiphase potential increase in the time needed for the extension. (4) Polyneuritis (polyneuritis) mainly to the distal extremities Huai symmetrical peripheral sensory - obstacles, lower motor neuron paralysis and nerve obstacles. Their paralysis of the characteristics of the distal limb symmetry lower motor neuron paralysis, according to the severity of nerve involvement. for the whole of paralysis, paraparesis. Reduce muscle tension, reduce or tendon reflexes disappear and ankle reflex reduce knee reflex often than earlier. There may be muscle atrophy, which was characterized by proximal to the distal weight. Leg muscle atrophy to the tibialis anterior, peroneus muscle, upper extremity muscles to bone, muscle vermis, and hypothenar muscle Obviously, there will be hands foot drop, firms can enter multi-threshold was gait. (5) the radial nerve palsy radial nerve palsy is the main performance wrist, the fingers and thumb can not be extended outreach, wrist sag, thumb and the first and second metacarpal gap back feeling dissipated or disappeared. Damage by different sites, different, axilla addition to the wrist injury ptosis, paralysis because of triceps and elbow can stretch by brachioradialis muscle paralysis and forearm supination of the forearm was not the elbow flexion, such as the humerus 1 / 3 injury, Triceps function is good. When injury or distal humerus in an arm / 3:00, brachioradialis muscle, muscle rotation, the radial extensor muscle function preservation, forearm were 1 / 3 the following injury, only EDC loss of function, without wrist ptosis. If the wrist injury may occur dyskinesia symptoms. (6) the ulnar nerve palsy (defined as of ulnar nerve) ulnar nerve palsy. Finger radial deviation, and ulnar outreach to weaken the movement and pinkie obstacles, hypothenar muscle and bone interosseous muscle atrophy. Palm and the back of the hand and the entire ulnar pinkie and ring finger flexor part of the sensory dysfunction. (7) carpal tunnel syndrome (caypal tunnel syndrome) may fracture, Wrist injury or transverse ligament thickening caused median nerve compression. Mainly out of the finger flexor weakened, the thumb and index finger could not bend, not opposing thumb palm movements, thenar muscle atrophy. No. 1 ~ 3 and 4 refer to refer to the half, palm radial sensory dysfunction. Local skin is dry and cold, and the fingernail edge. Autonomic dysfunction, and other symptoms. (8) the common peroneal nerve palsy (paralysis of common peroneal nerve ) have injured fibula and tibia muscle before the paralysis of muscles. Performance of foot drop, adequate and sufficient practice not dorsiflexion, and heel walking difficult. Walk, held Height, when landing at the foot toe after dropping an entire foot and gait similar to the chicken, known as cross-threshold gait. Anterolateral leg and foot sensory dysfunction.