Treatments for Paraplegia
Paraplegia: Research Doctors & Specialists
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Hospital statistics for Paraplegia:
These medical statistics relate to hospitals, hospitalization and Paraplegia:
- 0.016% (2,023) of hospital consultant episodes were for paraplegia and tetraplegia in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 86% of hospital consultant episodes for paraplegia and tetraplegia required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 68% of hospital consultant episodes for paraplegia and tetraplegia were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 32% of hospital consultant episodes for paraplegia and tetraplegia were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 17% of hospital consultant episodes for paraplegia and tetraplegia required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Medical news summaries about treatments for Paraplegia:
The following medical news items
are relevant to treatment of Paraplegia:
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Book Excerpts: Treatment of Paraplegia
Treatments of Paraplegia: Online Medical Books
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for more information about the treatments of Paraplegia.
Paraplegia:
Treatment
(In a Page: Signs and Symptoms)
- Paralysis or paraplegia is best managed by identifying and treating the underlying cause
–In cases of compressive lesions of the spinal cord, cauda equina, or nerve roots, surgical therapy is usually required
–Traumatic spinal cord injury often requires surgical stabilization; also, acute high-dose steroid treatment is effective in improving outcomes of traumatic myelopathy
-
Spinal dysraphism is often treated surgically
-
Infectious myelopathies: Antimicrobial agents
-
Multiple sclerosis: Acute exacerbations may be treated with steroids; prevent exacerbations with interferons, glatiramer acetate, and mitoxantrone
-
Guillain-Barré syndrome: Plasmapheresis or IVIG within 2 weeks of onset of symptoms
-
Physical therapy, assistive devices, orthotics, and wheelchairs may all be beneficial in improving the functional abilities of patients with paraplegia/paresis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Facial Paralysis & Bell's Palsy:
Treatment
(In a Page: Signs and Symptoms)
- Bell's palsy
–IV acyclovir and corticosteroids may lead to better recovery and less neuronal degeneration
–Tape eye and use eye shade to protect the eye during
sleep
–Massage of weakened muscles
–Electrical stimulation of paralyzed muscles in cases with
delayed recovery
-
In other cases, treat the inciting causes (e.g., control of blood pressure and hyperlipidemia in patients with CVA, antibiotics for patients with Lyme disease, antivirals in Ramsay Hunt's syndrome, steroids for sarcoidosis)
-
Consider neurologic referral
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Facial Paralysis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treat underlying cause, if identified
–E.g., tympanomastoidectomy for cholesteatoma, resection or chemoradiation for malignancy
-
Psychological counseling when studies indicate expected poor prognosis
- Eye care
–Prevent exposure and drying of eye: Artificial tears, lubricating ointment, and moisture chamber at night
–Ophthalmologic exam to rule out exposure keratitis
–Surgical correction: Tarsorrhaphy, upper lid gold
weight or spring placement
-
Pharmacologic
–Steroids: Recommended, but exact benefit unclear
–Acyclovir: Suspected viral etiology of Bell palsy
-
Surgery
–Facial nerve decompression
–Facial reanimation procedures (nerve and/or muscle
grafting and/or transpositions)
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Analgesia:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, position the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Paralysis:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP, and attempt to keep his head straight and facing forward.
Evaluate the patient’s respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he can’t respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Vocal cord paralysis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment for unilateral vocal cord paralysis consists of injection of Teflon into the paralyzed cord, under direct laryngoscopy. This procedure enlarges the cord and brings it closer to the other cord, which usually strengthens the voice and protects the airway from aspiration. Thyroplasty also serves to reposition the vocal cord, but in this procedure an implant is placed through a neck incision. The ansa cervicalis nerve transfer allows for reinnervation of the muscles of the vocal cord. Bilateral cord paralysis in an adducted position necessitates a tracheostomy.
Alternative treatments for adults include endoscopic arytenoidectomy to open the glottis, and lateral fixation of the arytenoid cartilage through an external neck incision. Excision or fixation of the arytenoid cartilage improves airway patency but produces residual voice impairment.
Treatment for hysterical aphonia may include psychotherapy and hypnosis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Analgesia:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Suspect spinal cord injury if the patient complains of unilateral or bilateral analgesia over a large body area, accompanied by paralysis. Immobilize his spine in proper alignment, using a cervical collar and a long backboard, if possible. If a collar or backboard isn’t available, place the patient in a supine position on a flat surface and place sandbags around his head, neck, and torso. Use correct technique and extreme caution when moving him to prevent exacerbating the spinal injury. Continuously monitor respiratory rate and rhythm, and observe him for accessory muscle use because a complete lesion above the T6 level may cause diaphragmatic and intercostal muscle paralysis. Have an artificial airway and a handheld resuscitation bag on hand, and be prepared to initiate emergency resuscitation measures in case of respiratory failure.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Paralysis:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP.
Evaluate respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he’s unable to respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Vocal cord paralysis:
Treatment
(Handbook of Diseases)
In unilateral vocal cord paralysis, treatment consists of injection of Teflon into the paralyzed cord, under direct laryngoscopy. This procedure enlarges the cord and brings it closer to the other cord, which usually strengthens the voice and protects the airway from aspiration.
Thyroplasty also serves to medialize the vocal cord, but in this procedure an implant is placed through a neck incision. The ansa cervicalis nerve transfer allows for reinnervation of the vocal cord muscles. Bilateral cord paralysis in an adducted position necessitates tracheotomy.
Alternative treatments for adults include encloscopic arytenoidectomy to open the glottis, and lateral fixation of the arytenoid cartilage through an external neck incision. Excision or fixation of the arytenoid cartilage improves airway patency but produces residual voice impairment. Treatment of hysterical aphonia may include psychotherapy and hypnosis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Analgesia:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Maintain spinal alignment during transport for laboratory or radiologic procedures. Monitor the patient’s vital signs and neurologic assessment closely. Provide continuous emotional support to the patient and his family.
Prevent pressure ulcer formation by such measures as meticulous skin care, massage, and frequent repositioning, especially when significant motor deficits hamper the patient’s movement. Guard against scalding by testing the water temperature before the patient bathes.
Patient teaching
Explain all tests and procedures. Advise the patient to test the water at home using a thermometer or a body part with intact sensation before showering or bathing.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Paralysis:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Because a paralyzed patient is particularly susceptible to complications of prolonged immobility, provide frequent position changes, meticulous skin care, and frequent chest physiotherapy. He may benefit from passive range-of-motion exercises to maintain muscle tone, application of splints to prevent contractures, and the use of footboards or other devices to prevent footdrop. If his cranial nerves are affected, the patient will have difficulty chewing and swallowing. Provide a liquid or soft diet, and keep suction equipment on hand in case aspiration occurs. Feeding tubes or total parenteral nutrition may be necessary with severe paralysis. Paralysis and accompanying vision disturbances may make ambulation hazardous; provide a call light and show the patient how to call for help. As appropriate, arrange for physical, speech, or occupational therapy.
Patient teaching
Provide information and referrals to home care and other support services, which may include social services, occupational therapy, speech therapy, physical therapy, and wound care. Assess the home environment and provide information to the family about safety measures and physical alterations that may be required to allow wheelchair access and maneuverability. Provide teaching on equipment that may be needed and used at home.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Paralysis:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If paralysis has developed suddenly, suspect trauma or an acute vascular insult. After ensuring that the patient’s spine is properly immobilized, quickly determine his level of consciousness (LOC) and take his vital signs. Elevated systolic blood pressure, widening pulse pressure, and bradycardia may signal increasing intracranial pressure (ICP). If possible, elevate the patient’s head 30 degrees to decrease ICP.
Evaluate respiratory status, and be prepared to administer oxygen, insert an artificial airway, or provide intubation and mechanical ventilation, as needed. To help determine the nature of the patient’s injury, ask him for an account of the precipitating events. If he’s unable to respond, try to find an eyewitness.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Analgesia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for spinal X-rays and imaging studies, and maintain spinal alignment and stability during the tests.
▪ Focus your care on preventing further injury to the patient because analgesia can mask injury or developing complications.
▪ Prevent formation of pressure ulcers through meticulous skin care and frequent repositioning, especially when significant motor deficits impair the patient's mobility.
▪ Guard against scalding by testing the patient's bath water temperature before he bathes.
Patient teaching
▪ Advise the patient to test bath water temperature at home using a thermometer or a body part with intact sensation.
▪ Explain all tests and procedures.
▪ Teach the patient about the diagnosis, once established, and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Paralysis:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Provide frequent position changes and meticulous skin care to prevent skin breakdown.
▪ Administer frequent chest physiotherapy.
▪ Perform passive range-of-motion exercises to maintain muscle tone.
▪ Apply splints to prevent contractures and footboards or other devices to prevent footdrop.
▪ Provide a thickened liquid or soft diet, and keep suction equipment on hand in case aspiration occurs, if the patient has difficulty chewing or swallowing.
▪ As appropriate, arrange for physical, speech, swallowing, or occupational therapy.
Patient teaching
▪ Explain all diagnostic tests and procedures.
▪ Explain the disorder and treatment plan.
▪ Teach the patient and his family how to prevent complications.
▪ Provide referrals to social and psychological services.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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