Paralysis of the hand

What is hand paralysis? Correctly this term is the total absence of motor function of the upper limb.

If movements in the hand are present, but they are limited in amplitude and strength, then one should speak of incomplete paralysis, or of paresis.

[1], [2]

Epidemiology

Epidemiology of the disease is as follows: 1.5 cases per 1000 newborns (data for Russia as of 2000). Pathologies are susceptible to both boys and girls. The most common is right-sided obstetric paralysis.

[3]

Causes of the paralysis of the hand

Both paralysis and paresis are most often caused by disorders in the work of the nervous system, specifically active centers that are responsible for voluntary movements, as well as the conducting channels of the central and peripheral nervous system.

[4], [5]

Risk factors

The main risk factors that lead to such disorders can be as follows:

• traumatic injuries, craniocerebral trauma;
• serious disorders of metabolic processes;
• infectious damage to the central nervous system (inflammation of the meninges, poliomyelitis, tuberculosis, etc.);
• exposure to toxic substances (eg lead intoxication);
• malignant brain lesions;
• trophic disorders;
• hereditary weakness of the nervous system;
• congenital disorders of innervation.

[6], [7], [8], [9], [10]

Symptoms of the paralysis of the hand

The first signs of the beginning paralysis of the hand are the limitation of the amplitude of arbitrary movement, the appearance of weakness. Weakness in the limb originates from the carpal part, gradually spreading to the proximal muscles. The most simple way to determine the growing paresis is to shake hands.

• Paralysis of the left arm is a frequent phenomenon accompanying cerebral blood flow disorder, cerebral form of atherosclerosis, hypertensive disease. In this case, paralysis of the upper limb can occur simultaneously with the lesion of the lower limb, as well as with the paresis of the sublingual and facial nerve.
• Paralysis of the right hand can be a consequence of a dislocation of the shoulder joint, damage to the plexus of the shoulder. The patient loses the ability to pull the limb aside, lift it. Movement in the elbow joint is extremely limited, or absent at all.
• Paralysis of the fingers occurs when the nerve is damaged in the middle part of the shoulder. The most frequent manifestation of finger paralysis is the weakness of the hand and the lack of motor activity in the phalanges. In some cases, there is a change in the sensitivity of the back of the thumb.
• Partial paralysis of the hand is a condition where the strength and amplitude of movement in the joints are relatively preserved. To determine partial paralysis, the Barre test is used: the patient is asked to stretch his arms in front of him and keep them that way for as long as possible. If there is paresis, or partial paralysis, then the limbs immediately drop.
• Obstetric paralysis of the hand is the immobilization of the upper limb in a newly born child. This condition is usually due to damage to the shoulder or nerve endings during labor.

Stages

Birth paralysis has four stages of development:

• acute stage (during the period of newborns);
• early recovery stage (up to one-year-old age);
• late recovery stage (up to 3 years of age);
• residual stage (after 3 years).

Obstetric paralysis is accompanied by a passive position of the affected arm. There are also cervical symptoms, which indicates damage to the cervical vertebrae and spinal cord.

[11],

Forms

Paralysis is central (spastic) and peripheral (flaccid).

The central form of paralysis is due to a malfunction in the motor central nerve cells. With this kind of paralysis deep reflexes intensify, hypertonicity arises and those reflexes appear that should not normally be present (for example, the reflex of Babinski, Rossolimo, etc.).

The lax form of paralysis is a consequence of damage to the peripheral motor nerve cells. This paralysis is characterized by a decrease or loss of reflexes, hypotension, atrophy. Sometimes the condition is aggravated by muscle twitching.

Paralysis in most cases occurs due to severe lesions of the nervous system. Only sometimes the disease is associated with functional malfunctions. Most often - this is the result of damage to certain zones responsible for movement, which leads to the appearance of:

• monoparality or monoparesis (paralysis of one hand);
• paraparality or paraparesis (two-hand lesions);
• hemiplegia (lesions of the arm and leg on the left or right);
• triplegia (lesions of three limbs);
• tetraplegia (defeat of all hands and feet).

In this case, paralysis can capture the entire limb, or only the distal or proximal part of it.

[12], [13], [14], [15]

Complications and consequences

Paralysis of the hand is only one of the symptoms or consequences of a major illness, so the development of complications and prognosis depends on how correctly the diagnosis is made and the treatment is prescribed.

[16], [17], [18], [19]

Diagnostics of the paralysis of the hand

Diagnosis of hand paralysis is carried out on the basis of anamnesis and examination of the patient. With complete paralysis, the upper limb loosely hangs down, the elbow joint is bent, the fingers are bent. There is no motor activity.

In addition, the doctor may prescribe certain tests:

• general blood analysis;
• blood chemistry;
• general urine analysis;
• examination of cerebrospinal fluid.

Instrumental diagnostics can include:

• EMG - electromyography - a technique for studying the bioelectrical potentials of the neuromuscular system;
• computer or magnetic resonance imaging;
• investigation of the innervation of peripheral nerve fibers.

[20]

Differential diagnosis

Differential diagnosis is carried out taking into account the varieties of polyneuritis and polymyositis, which can also manifest themselves as symptoms of paresis and paralysis.

[21], [22], [23], [24], [25], [26], [27]

Treatment of the paralysis of the hand

Complex therapy of hand paralysis should include:

• drug treatment;
• physiotherapy;
• massage procedures;
• Exercise therapy;
• drug blockade.

Selection of the method of treatment is carried out individually, taking into account the underlying disease, which provoked paralysis.

Drug treatment primarily involves the appointment of medications, muscle relaxants, as well as medications that improve cerebral circulation.

		Dosing and Administration			Side effects	Special instructions
Baclofen		Assign an individual scheme of ½ to 2 tablets three times a day during meals.			Drowsiness, nausea.	It is not recommended to take with diseases of the digestive system.
Sirdalud		Assign from 2 to 4 mg three times a day.			Fatigue, dizziness, thirst, lowering of blood pressure, nausea.	Do not apply simultaneously with Fluvoxamine and Ciprofloxacin.
Diazepam		The average daily dosage is 5 mg. The course of treatment is 1 month.			Fatigue, drowsiness, headache, weakness.	The course of treatment is completed gradually to avoid withdrawal syndrome.
Dantrolene		The average daily dosage is 25 mg. The maximum daily dosage is 400 mg.			Depressive conditions, headache, dyspepsia, eating disorders.	Do not appoint children under 5 years.
Cinnarizine		Usually appoint 1 tablet three times a day.		Drowsiness, pain in the head, thirst, sweating, increased fatigue.		The preparation contains lactose.
Stugeron		Assign 1 tablet (25 mg) three times a day.		Dyspepsia, headache, dry mouth.		In diseases of the gastrointestinal tract, it is recommended that the drug be taken immediately after a meal.

Vitaminotherapy is the second important component of the successful treatment of paralysis. Scientists have proved that the lack of certain vitamins and microelements in the body can disrupt the activity of the nervous system. So, when choosing a multivitamin drug should pay attention to the presence of such vitamins:

• retinol (Vit. A) - helps in the formation of new cellular structures;
• vitamins gr. B - normalize the work of nerve cells, improve blood circulation in the brain;
• ascorbic acid (Vit. C) - strengthens and restores vascular walls, including in the brain;
• vitamin D - maintains an optimal picture of the blood;
• vitamin K - improves metabolic processes and blood circulation;
• tocopherol (Vit. E) - an antioxidant, supports the work of the immune system.

Physiotherapeutic treatment involves the use of thermal procedures and methods of stimulation of peripheral nerves:

• paraffin and ozocerite applications;
• electrostimulation (apparatus "Mioton").

In addition, it is recommended to apply massage and manual therapy, which will allow maximum relaxation of the muscles cramped with spasm. During a massage, it is important to avoid painful and gross techniques that can increase muscle tone.

An alternative treatment for hand paralysis involves a variety of methods. The prescriptions presented below can be used both to alleviate the patient's condition and to prevent paralysis as a whole.

• Take 25 fresh pine cones, pour them 1 liter of vodka and insist for 3 weeks. Finish the drug and take 1 tsp. Three times a day for half an hour before a meal.
• Prepare an infusion of rhizomes of the peony: 1 tsp. Raw materials soak in 250 ml of boiling water. After an hour, filter and drink according to 1 tbsp. L. Three times a day, a few minutes before meals.
• Make a mixture of 20 grams of melissa, 20 grams of thyme, 10 grams of thyme, mint, motherwort and mistletoe. Pour 1 tbsp. L. Raw 250 ml of boiling water, insist for an hour, filtered. Drink 100 ml twice a day between meals.
• Grind fresh dates in mashed potatoes. Use three times a day for a full tablespoon, you can with milk. The course of therapy - 1 month.
• Rasparit elderberry berries, grind in puree and make a compress on the affected limb. Repeat the procedure twice a day.

Treatment with herbs provides for the use of infusions or alcohol tinctures. Herbal teas can be cooked using various combinations of herbs, mixtures, often using arbitrary proportions. When paralysis of the hand, the following plants and their combinations are recommended:

• sage - has anti-inflammatory effect, stimulates immunity, activates blood circulation;
• Valerian - calms, improves the work of the nervous system, relaxes and eliminates spasms;
• thyme - eliminates neuralgia and neurosis, relieves inflammation and normalizes sleep;
• Leonurus - normalizes blood pressure, calms the nervous system, stabilizes heart activity.

Homeopathy can be of particular benefit in case of paralysis of the hand - it is a relatively new type of treatment that involves the use of drugs exclusively on a natural basis. Such homeopathic drugs are easily tolerated by patients, have minimal side effects and are considered very effective.

	Dosing and Administration		Side effects	Special instructions
Gelziumium	10 drops 3 times a day.		Relaxation of smooth muscles, involuntary urine and caloric discharge.	The active component of the drug is a toxic substance of the neuro-paralytic effect, therefore the treatment should be carried out only under the supervision of the doctor.
Conium	Take 8 granules 5 times a day, under the tongue. Duration of treatment - 2 months.		Lowering blood pressure, indigestion.	An overdose can cause symptoms of poisoning.
Nervocheel	1 tablet under the tongue, for 2 to 3 months.		Allergic manifestations.	The preparation contains lactose.
Spiegelon	1 tablet three times a day for 30 minutes before meals.	Allergic manifestations.		It is not used in children under 3 years old.

Operative treatment is used if conservative measures are recognized as ineffective. Orthopedic surgery should have strict indications for its conduct:

• improvement of motor amplitude;
• ensuring patient self-care and improving the quality of life.

In severe cases, they resort to neurosurgical operations.

Exercises of Dikul for paralysis of the hand

The technique of Valentine Dikul helped many people get rid of problems with the spine and joints. If you persevere and carry out the proposed exercises regularly, you can not only improve your health, but also avoid disability and return to your normal lifestyle.

The main rule that Valentin Dikul adheres to is the absence of inaction. Movement - this is life, and good health for many years.

What exercises does Dikul offer in paralysis of the upper extremities?

1. The patient lies on his back, his legs are slightly apart. Without changing the position of the legs, it turns the body to the right and to the left.
2. The patient lies on his back, legs together. With the motionless body turning both legs to the right and left, as if twisting them.
3. The patient lies on his stomach and raises his head and shoulders.
4. In the standing position, turns the pelvis to the left, to the right, forward and backward.
5. The patient lies on his back, legs bend at the knees. Raises the head and upper body by 45 °.

If the exercises with paralysis of the arm are difficult to perform, you can see a doctor who will choose exercises with light weight. The proposed training is recommended to be performed regularly, sometimes - throughout life.

Prevention

Prevention of paralysis is the prevention of diseases and conditions that can cause deterioration of limb movements. To do this, you must adhere to a healthy lifestyle and implement a number of recommendations:

• maintain physical activity;
• to abandon bad habits, not to abuse alcohol and not to smoke;
• To eat healthy food, to refuse products of questionable quality;
• do not abuse salty foods;
• drink enough fluids;
• periodically check the level of cholesterol and glucose in the blood;
• regularly monitor blood pressure.

[28], [29], [30]