Paralysis in the leg

definition

The collective term “symptoms of paralysis in the leg” includes all clinical pictures in which the leg is no longer able to perform the physiologically possible movements willingly or with adequate force. This can be caused by diseases of the muscles themselves, but also by loss of function or malfunction of the nerves supplying the muscles.

The extent of the symptoms of paralysis in the leg varies depending on the cause, whereby one generally between a complete paralysis of the Leg muscles (Plegia) and a paralysis in which movement is possible in a weakened manner (Paresis), differs.

As Monoparesis respectively Monoplegia of the leg is the name given to the situation when only one leg is affected by the paralysis, whereas the Paraparesis or also the Paraplegia the legs describes the paralysis of both legs.

causes

Symptoms of paralysis in the leg can basically arise on three levels in the body. So the cause can be im Nervous system, be located in the muscle itself or at the junction between the nerve and the muscle.

If the nervous system is responsible for the symptom of paralysis, several triggers can lead to the symptoms. Central, i.e. in the brain, is often a stroke the cause of the paralysis. A violation of the Backmarks in form of a Paraplegia lead to the same disorder.

Is the damage to the nervous system outside of the brain and spinal cord (central nervesystem), one speaks of a peripheral damage. Here, a nerve can be injured, for example, by trauma or by a disc prolapse (Prolapse) are compressed so that it can no longer perform its function of causing the muscle to contract.
If the cause of the symptoms of paralysis in the leg is in the muscles themselves, hereditary muscle diseases are usually responsible, in which errors in the structure of the individual muscle cells mean that the muscles cannot perform their physiological function. This is for example with the Muscular dystrophies the case.

If the signal transmission from the nerves to the muscles is disturbed, one speaks of disorders at the neuromuscular junction. These diseases are rather rare and usually occur as part of hereditary diseases.

After all, paralysis in the leg can still be caused psychologically and was, for example, in the case of the psychiatric clinical picture of dissociative disorder observed.

Symptoms of paralysis from a herniated disc

A herniated disc in the lumbar spine can sometimes lead to paralysis in the leg. This is due to the fact that the nerves responsible for the legs emerge from the spinal cord in the lumbar spine area and can consequently be compressed by a herniated disc in this area. This can restrict the lifting of the big toe or, in the case of a more extensive herniated disc, paralyze entire muscle groups. Symptoms of paralysis are usually perceived as more threatening than sensory disturbances (tingling, numbness) and are therefore more likely to result in an immediate visit to the doctor. This is a good thing: with quick (usually surgical) treatment, an immediate, significant improvement in the symptoms of paralysis can often be achieved.
Most often, a herniated disc occurs in the lumbar spine area between the fourth and fifth vertebrae. If the corresponding nerves are impaired, one speaks of the L4 syndrome or, in the case of deeper damage localization, of the L5 syndrome The knee and the flexion of the hips are to be expected. In L5 syndrome, the lift of the foot is affected by motor, which means that the foot and the big toe can no longer be lifted. This results in a noticeable gait pattern when walking, as the person concerned tries to compensate for the lack of elevation of the feet by flexing the knees and hips more strongly.

Read a lot more information about this under our topics

• Symptoms in the legs of a herniated disc in the lumbar spine and
• Herniated disc L4 / L5
• L5 syndrome

Symptoms of paralysis from MS

In multiple sclerosis (MS), the nerve sheaths that surround the nerves like a protective and insulating sheath are damaged by an inflammatory process, which affects the function of the entire nerve. As a result, paralysis is one of the symptoms caused by MS. Since the MS in most cases progresses in a bursty manner, the symptoms of paralysis express themselves as an overnight unsteady gait in many of those affected. An immediate medical examination can confirm a suspected MS flare-up. Shock therapy containing cortisone can then reduce the duration and intensity of the flare-up and also improve the long-term prognosis of MS.

Please also read our article on this Multiple sclerosis.

Paralysis in Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) is an inflammation of several nerve roots. The mechanisms underlying the disease are not yet fully understood, but it can be assumed that there is an autoimmune disease affecting the membranes of the nerve cells. A recent bacterial or viral infection can often be assumed to be the trigger for the autoimmune reaction.
The GBS is characterized by ascending paralysis, i.e. starting from the legs and spreading upwards. These typically occur symmetrically, i.e. on both sides.

For more information, see Guillain-Barré Syndrome (GBS)

Symptoms of paralysis after a vaccination or injection

Obviously, symptoms of paralysis in the leg do not occur after injections into the shoulder, but only after injections into the gluteal muscle. But even in the latter case, such symptoms are the absolute exception. The symptoms of paralysis are then due to the fact that the syringe hit and damaged a nerve that is responsible for the motor supply to the leg muscles. The paralysis is often accompanied by a sensory disorder in the form of numbness. If the paralysis is actually due to the injection, it will appear right after the vaccination. A later occurrence of symptoms of paralysis cannot be explained by the injection and should be examined for other possible causes.

You might also be interested in: Pain after vaccination

Symptoms of paralysis after an operation

Symptoms of paralysis in the leg following an operation are usually not to be assessed as too worrying if a so-called spinal anesthesia (Anesthesia of the spinal cord) because the anesthesia in the legs does not suddenly disappear after the operation. In addition, swelling as a result of an operation on the leg (e.g. joint operation) can significantly limit the mobility of the leg and thus simulate signs of paralysis. However, special attention should be paid to the possible occurrence of paralysis in the leg after back operations, especially after back surgery. in the lumbar spine area. This is where the nerves from the spinal cord emerge, which are responsible for supplying the legs. As a result, these are particularly at risk during operations in the lumbar spine area. But even with such operations, symptoms of paralysis only occur relatively rarely and if they do, they usually improve considerably within a few days.

Please also read our article on this Complications of spinal anesthesia.

Symptoms of paralysis after a panic attack

Panic attacks often include not only the eponymous sudden feeling of fear, but also physical symptoms such as palpitations, sweating, swallowing disorders, shortness of breath or paralysis. The latter are often perceived as particularly alarming by those affected and can thus extend the duration of the panic attack. In this case, it is important to inform those affected beforehand that such symptoms of paralysis are to be interpreted as an expression of the panic attack and that they usually disappear again within minutes.

For more information, see Panic attack.

Diagnosis

Symptoms of paralysis in the leg should primarily be clarified neurologically. With the help of the physical, neurological examination, which includes the assessment of a reflex status, the doctor can determine the cause and the place of origin of the paralysis and initiate further diagnostic steps. Imaging methods such as CT or MRT are often used here. If it is suspected that the peripheral nerves are responsible for the symptoms of paralysis, an examination of the nerve conduction velocity can be helpful. In addition, if there is justified suspicion, a muscle biopsy (sampling) must be carried out in order to rule out a disease of the muscles.

Concomitant symptoms

All causes are connected by the main symptom of paralysis in the leg, which leads to the loss of the ability to move the leg at will, which can lead to a loss of strength up to gait disorders or even complete paralysis of the leg. Often there is an accompanying loss of sensitivity of the skin, which affects the sense of touch, the perception of temperature and also the perception of vibration. If the corresponding muscles are no longer used due to the paralysis of the leg, what is known as atrophy results, i.e. a reduction in muscle mass, whereby the leg appears thin in relation to the stressed muscles and as Stork leg referred to as.

If a stroke is responsible for the paralysis, it usually only affects one half of the body and is often accompanied by paralysis of the arm and face muscles on the same side, which manifests itself in a weakness in the arm and a drooping corner of the mouth.

Read more about this under What happens if I have a stroke?

If there is complete paraplegia, both legs are affected by the paralysis and, depending on the severity of the spinal cord injury, other parts of the body, such as the arms, are also affected.

In addition, the cross-sectional symptoms that affect the legs usually also include incontinence and, in the acute phase, also a loss of muscle reflexes. Accompanying symptoms of a herniated disc are often severe back pain that can radiate into the legs and, depending on the severity, even the function of the bladder and rectum may be disturbed. In addition, the muscles' own reflexes can be weakened here compared to the other side not affected by the paralysis, which a doctor can determine in a neurological examination.

Read more on the subject here: Paraplegic syndrome.

Symptoms of paralysis in the leg on the right, left or both sides

If symptoms of paralysis only occur on one side in the leg, the possible causes can be a stroke, but also damage to the nerve that supplies the leg in question. Whether the paralysis occurs on the right or left is important for the exact localization of the damage. If paralysis occurs in both legs, this indicates damage to the spinal cord or a pathophysiological mechanism, for example a muscle disease that is generalized and cannot be assigned to a specific place of origin. The differentiation of the paralysis depending on the affected leg plays an important diagnostic role.

Symptoms of paralysis in the leg during pregnancy

Through the changes in the body as part of a pregnancy In rare cases, unfavorable constellations arise that cause paralysis in the leg. The growth of the child and the associated increase in the size of the abdomen in combination with wearing too tight trousers can lead to pinching and thus paralysis of skin nerves. This can cause sensory disorders and abnormal sensations in the skin of the thigh. The expansion and loosening of the pelvis during pregnancy can also cause nerve entrapment. The possible consequence is partial to complete paralysis of the affected leg.

It is not uncommon Sciatic nerve, which arises from the lumbar spine, is affected by the compression or irritation due to the unusual load. An irritation of this nerve manifests itself symptomatically through a mostly pulling pain that radiates over the buttocks and into the leg. The muscles of the leg can feel numb or show weakness in the form of paralysis. Since the ligaments are more flexible than before due to hormonal processes during pregnancy, there are more frequent herniated discs, which can become symptomatic in leg paralysis and require clarification. Also caused by the change in the hormonal balance, there is increased water retention during pregnancy, which also affects the connective tissue around nerves. The swelling of this tissue can lead to nerve entrapment and paralysis in the leg.

Also read the topic Back pain in pregnancy

therapy

The treatment of symptoms of paralysis in the leg depends largely on the underlying cause and includes a spectrum from surgical care, for example for the treatment of a herniated disc, to drug therapy in the case of muscular disorders, to conservative measures. This is one of those physical therapy and physical therapy, which aims to relieve symptoms and build and strengthen muscles. In the case of paraplegia, according to current medical knowledge, there are as yet no curative treatment methods. In the treatment of paralysis, in addition to conservative measures such as physiotherapy, good psychological and social help is particularly important so that the patient can adapt to the new living conditions and lead as independent a life as possible with changes in the home and at work.

consequences

The consequences of paralysis in the leg are diverse and are influenced by the cause and possible therapy options. So it is possible that the paralysis in the leg completely disappears and the person concerned no longer has any restrictions. The symptoms also often improve, so that either the paralysis is less pronounced or that accompanying symptoms disappear, which increases the patient's quality of life. However, persistence of the complaints, i.e. permanent paralysis, is also possible, which then often leads to serious life changes, for example occupational disability, restrictions in everyday life and loss of independence.