Paralysis of hands

Paralysis is a violation of motor activity, which is manifested by a complete lack of movement. If the movement is preserved, but for some reason is weakened to some extent, then such a violation is called paresis.

Pathology is divided into several types, depending on the place of injury and severity:

• paraplegia - paralysis of hands or feet
• quadriplegia - paralysis of both hands and feet
• hemiplegia - paralysis of the body from one side

[1], [2], [3]

Causes of hand paralysis

Paralysis of the hands can occur due to injuries, encephalomyelitis, infectious diseases (inflammation of the meninges, tuberculosis, viral encephalitis, poliomyelitis), metabolic disorders, diseases of the vascular system, cancerous tumors, severe poisoning.

Paralyzing the hands may be due to congenital or hereditary CNS diseases.

Among the toxic causes: a deficiency of vitamins B1, B6, PP, alcoholic polyneuropathy, poisoning with salts of heavy metals.

In some cases, paralysis occurs after injuries or fractures, in which the motor conducting center is damaged.

Often, paralysis occurs in mentally unhealthy people.

[4], [5]

Pathogenesis

Paralysis is divided into spastic and peripheral.

Spastic paralysis affects the central neurons responsible for the motor functions of the hand, which leads to pathological reflexes, muscle tone, strengthening of tendon and periosteal reflexes.

Peripheral lesions of peripheral neurons, in this case tendon and periosteal reflexes are completely absent, muscle tone is weakened.

Most often, paralysis of the hands is associated with peripheral lesions, central paralysis (transient) is extremely rare, which is caused by a violation of blood circulation in the brain with hypertension or cerebral atherosclerosis, convulsive epileptic seizures. Peripheral lesion develops due to damage to the nerves of the brachial plexus or 5 and 6 cervical vertebrae (usually of a temporary nature).

When the hand is paralyzed, it is impossible to raise or lower the hand, the mobility of the elbow joint is limited.

At the heart of the pathology, according to experts, is a neurological disorder due to a blow to the neck or shoulder (possibly with exercises, wrestling, falling, etc.).

Paralysis of the upper extremities can develop against the background of tick-borne encephalitis, when paralysis of the neck muscles, the shoulder girdle, proximal parts of the hands occurs during the fever.

Symptoms of hand paralysis

Paralysis of the hands is characterized by the lack of muscle strength, increased tone and spasm of muscles, with a significant violation of reflexes (strengthening or complete absence), not sensitivity to pain, impaired blood circulation.

Paralysis of hands and feet

It is believed that paralysis of the hands and feet (tetraplegia) occurs with severe injuries in the spinal cord, while the hand can paralyze completely or partially.

When tetraplegia affects 4, 5 and 6 cervical vertebrae, but the patient can bend or raise his hands. Damage of 6 and 7 cervical vertebrae leads to immobilization of the lower extremities, hands, wrist joints (the ability to bend arms and move shoulders remains).

Damage to the spinal cord in the lumbar or sternum, depending on the severity of spinal cord injury, can paralyze the legs above or below the knees.

Paralysis of the limbs can be spastic or peripheral.

Spastic paralysis is associated with damage to the central neurons.

Most often this type of tetraplegia occurs after a stroke.

Damage to peripheral neurons results in peripheral paralysis of the extremities. For such tetraplegia, the absence of one or more reflexes and atrophy are characteristic.

Paralysis can develop after any disturbance in the nervous system and this condition can be associated with a variety of causes - infections, viruses, injuries, etc. According to statistics, paralysis of the limbs in most cases is caused by trauma (in accidents, falls, unsuccessful performance of dangerous exercises and etc.), paralysis is less common against the background of tumor growth, which presses on nerve fibers in the spinal cord, congenital pathologies, inflammatory processes in the spinal cord.

Spastic paralysis leads to a significant impairment of motor functions, a strong muscular tension, but without atrophy. The paralytic also shows a decrease or absence of reflexes in the peritoneum. Violation of peripheral neurons causes damage to some muscles, which leads to complete or partial absence of reflexes.

Paralysis of the left hand

Paralysis of the hands is the most common problem in people who have had a stroke, which breaks the blood circulation of the brain and causes serious CNS damage.

After a stroke, in addition to impairment of mobility, the patient's arm is disturbed by a strong spasm of the muscles due to prolonged immobility, loss of elasticity and easy shortening.

Paralysis of the left arm may occur due to damage to the radial nerve, which can lead to weakening or complete paralysis of the muscles associated with it (flexors and extensors of the hand, fingers, forearms, shoulder, etc.).

In such cases, the patient can not perform some movements by hand - to move his fingers, bend his elbow, etc.

The cause of paralysis can be various injuries and hand injuries in the region of the humerus, usually paralysis occurs after fractures or dislocated shoulder.

Also, possible causes include the transmission of the radial nerve (for example, after a long and strong pressure on the arm under the arm under the arm, most often during alcoholic intoxication).

Less often, the paralysis of the radial nerve can arise because of the doctors' mistake (when injecting drugs into the shoulder), infections, poisoning with poisonous substances.

It should be noted that damage to the radial nerve can lead to an excessively tight time strap.

Paralysis of the right hand

Paralysis of the right hand can develop after a stroke, damage to the radial nerve, tumors.

Frequent causes of paralysis are injuries (with falls, fractures, dislocations, etc., including generic ones).

Also, paralysis of the hands can be associated with nervous overexertion, by the movement of blood vessels. Paralysis of the hand can occur in hypertensive patients with too high a blood pressure (more than 200m of ps).

Recently, paralysis of the hands is often diagnosed after overstraining of the shoulder muscles, headaches or dizziness.

Such pathology is often found in perforators, stenographers, literary workers, etc.

Paralysis of the fingers

The ulnar and median nerves emerging from the plexus of neurons in the shoulder are responsible for flexion and extension of the fingers. Damage to the ulnar nerve can cause paralysis of an anonymous little finger and a finger, the middle of the thumb, index finger and middle finger.

Damage to the nerves can be with a fall, impact, even while riding a bicycle in the wrong position.

Often paralysis of hands and fingers occurs with excess weight, especially if there are loads on the wrist (for example, in pianists).

Obstetric hand paralysis

Obstetrical paralysis refers to the birth trauma of the brachial plexus during prolonged or severe childbirth, as well as in the case of an abnormal position or too large a child's size.

Damage can lead to partial or complete disruption of the functionality of the shoulder and muscles responsible for hand movement or brushing.

The main symptom by which a diagnosis is made is the immobilized hanging arm of a child.

Often, such injuries of the brachial plexus are accompanied by damage to the sternoclavicular muscle, which provokes a torticollis (timely and competent treatment of a newborn will help prevent pathology).

There are several types of obstetric paralysis - the upper, lower and mixed. In most cases, upper paralysis is diagnosed, which is characterized by damage to the muscles and joints of the shoulder.

The lower form is diagnosed in about 10% of cases, while the muscles of the forearm and hand are damaged.

The most severe is the mixed form, in which there is complete paralysis of the hands.

Paralysis of the right arm and leg

Paralysis of the arm and leg on the right side is often a consequence of a stroke, this condition is characterized by a certain danger to the health and life of the patient. The right side usually paralyzes in hypertensive patients, with diseases of the nervous system, the heart. Often, except the arms and legs paralyzes the right side of the face.

The main problem after a stroke with paralysis of the right side is the speech deflection.

The paralysis of the hands after the stroke later is revealed, unlike the left-sided paralysis.

Failure of the left arm and leg occurs in a left-sided stroke, in which the brain cells in the left hemisphere are affected. The neuronal grid in man has a cross structure and when the left hemisphere is affected, the right side of the body is disrupted.

Paralysis of the left arm and leg

Left-sided paralysis of the limbs can also be a consequence of a stroke.

Failure of the right hemisphere, in addition to paralysis of the left side of the body, leads to absent-mindedness, depression, causeless aggression, memory loss, partial loss of sight, hearing, touch, wrong perception of colors.

Paralysis of the little finger of the left hand

Paralysis of the little finger can be associated with damage to nerves that are in the fingers or hands, lead to a similar pathology can excessive load, squeezing, trauma.

Partial hand paralysis

Paresis or partial paralysis of the hands is also associated with a violation of the central or peripheral nervous system.

Pareses are divided into organic (when you can determine the cause of impassability of nerve impulses) and functional (damage to the cerebral cortex).

Symptoms of partial paralysis are an increase in muscle tone in the arm, a violation of reflexes. Lead to this condition can multiple sclerosis, strokes, trauma, migraine, neoplasms, trauma (disease) of the brain or spinal cord.

To paresis of the extremities usually leads to a cerebral hemorrhage, also the birth injury of the brachial plexus can become the cause.

At paresis it is impossible to perform unconstrained movements, for example, to squeeze a hand into a fist.

The danger of paresis is that with incorrect treatment (or lack of therapy) the hand can completely paralyze.

With paresis, a person feels pain, with accompanying diseases there is rapid progression.

Often the cause of paresis are associated diseases, so treatment is aimed at eliminating the cause that led to pathology.

When injuries, it is necessary to sew damaged nerves, in tumors - surgical removal of the neoplasm, after a stroke - restorative treatment (massages, physiotherapy).

It is worth noting that in the treatment of paresis, the desire of a person to restore the mobility of the hands is of great importance, in addition, it is important to select a qualified specialist with sufficient experience in the treatment of such cases.

First signs

The first signs of paralysis of the hands is the restriction of mobility, a reduction in the volume of voluntary movements.

[6],

Effects

Paralysis of the hands is a serious condition, in which the ability to move the hand is completely lost, to perform any movements.

In addition to physical discomfort, an important aspect of paralysis is psychological consequences.

In a number of cases, the strong desire of the patient himself helps to restore the mobility of the hand, but the help of close people is of no small importance.

Any paralysis leads to a feeling of helplessness in a person, inferiority, causes severe inner experiences, down to depression.

Support for loved ones will help a person tune into a positive mood and improve the effect of treatment.

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

Complications

Paralysis of the hands can lead to neurologic disorders (complete or partial absence of force in the muscles), as well as to irreversible hardening of the muscles, immobility of the joints.

[11], [12]

Diagnostics

Hand paralysis is diagnosed on a 5-point scale:

• normal muscular strength - score 5
• the force is somewhat reduced, but the person is able to make active movements, overcoming resistance (for example, the counter pressure of the doctor) - score 4
• a person can not resist outside pressure - score 3
• man is not able to resist gravitational forces - score -2
• a person can make minor active movements by hand - score 1
• complete absence of active movements - score 0

Also during the examination, the doctor reveals other symptoms (lack of reflexes, facial asymmetry, muscle atrophy, etc.), how long the arm is stationary, which preceded paralysis (headaches, eating any cans, indigestion, fever, ), the place of work and residence of the patient (possibly professional activity or exposure to harmful substances caused paralysis).

[13], [14], [15], [16]

Analyzes

Analyzes are important during the diagnosis. When the hand is paralyzed, a blood test is done - general and toxicological.

The general analysis of blood can reveal inflammatory processes in the body, increase in the products of muscle metabolism.

Toxicological analysis of blood reveals signs of poisoning the body.

[17], [18]

Instrumental diagnostics

Instrumental diagnostics makes it possible to identify various diseases, evaluate muscular activity, identify abnormalities in tissues, and so on.

With paralysis of the hands, a test with paserin is usually administered, aimed at detecting myasthenia gravis (pathological fatigue of the musculature). The introduction of the drug in case of disease allows for a short time to restore strength in the muscles.

Electroneuromyography is carried out for the purpose of assessing the activity of the musculature, the speed of movement of nerve impulses along the fibers,

Electroencephalography is assigned to assess the electroactivity of various parts of the brain (with various diseases, it changes).

Computer or magnetic resonance imaging of the spinal cord and brain is designed to study the structure of the tissue and identify abnormalities, hemorrhages, neoplasms, pustular lesions, and places of decomposition of nervous tissue.

Magnetic resonance angiography is necessary to assess the patency and integrity of the arteries and identify possible neoplasms in the head.

Differential diagnostics

Differential diagnosis takes into account the spread and localization of muscle weakness.

Often, when a patient complains of a paralysis of one hand, weakness in the second appears, and also with complaints of weakness in the whole hand, the diagnosis makes it possible to establish the defeat of only one group of muscles. Quite often, patients with weakness in the hand imply a violation of movement (disorder), a decrease in sensitivity, restriction of mobility with arthritis, increased tone (with the development of Parkinson's disease).

[19], [20], [21], [22]

Treatment of hand paralysis

Treatment of paralysis of the extremities depends on the cause that led to the pathology.

Damage to the nerves (with injuries, fractures, tumors) can cause paralysis of the hands, in this case it is important to begin treatment in time. Usually, the load is reduced, the tire is placed on the wrist, physiotherapeutic procedures can also be prescribed at the doctor's discretion. Self-healing of the nerve is possible, but it takes quite a long time - from several months to several years.

In case of traumatic lesions of the hand, surgery may be required to restore the nerve patency, especially such treatment is necessary for fractures.

To restore the sensitivity and mobility of the hand after a stroke, it is necessary to take medications to improve blood circulation in the brain, special gymnastics to develop a paralyzed hand (usually done with the help of an outsider).

To prevent degenerative changes and improve circulation, massage and vitamin-mineral complexes are prescribed to maintain the whole organism.

Separately, it is worth mentioning obstetric paralysis, the treatment of which requires severity and form of trauma. In each case, the specialist selects individual treatment.

Sometimes a newborn needs the application of a fixing bandage, a tire.

Also, vitamins B, proserin, aloe, in combination with antispasmodics (euphyllinum, papaverine) are prescribed.

In addition to medicines, physiotherapy procedures (electrophoresis, mud applications, iodine-galvanization) are prescribed.

When the hand is paralyzed in combination with the torticollis, mud applications are applied to the neck, forearms and the neck (this method is highly effective in such pathologies).

Obligatory to children with birth trauma is appointed a special massage course.

Surgical treatment is not often prescribed, usually the operation is performed with ineffectiveness of other methods of treatment and is prescribed no earlier than 6 months after birth.

A child with such a trauma is restored with proper treatment in a few months, usually a full recovery occurs by 1.5 years.

Medications

Proserin improves the transmission of nerve impulses to the muscle, strengthens the motility of the gastrointestinal tract, increases the tone of the bronchi, bladder, the development of the endocrine secretion.

The drug should be taken only as directed by the doctor.

It is prescribed 2-3 times a day for 0.01-0.015 g, in the form of injections - 0.0005 g 1-2 times a day. The course of treatment on average 2 weeks.

Euphyllin has an antispasmodic, vasodilating effect, stimulates the respiratory centers, increases the heart rate, relaxes the smooth muscles, dilates the vessels in the brain, improves blood circulation, reduces pressure in the veins, and also intracranial.

It is prescribed for strokes at the initial stage.

Inside the drug take 0.1 - 0.2 g 2-3 times a day, intramuscularly appointed - 2-3 ml of 12% or 24% solution, intravenously - 5-10 ml of 2,4 solutions, rectally - 1 candle 2 times a day, in microclysters - 0.2-0.4 g.

The drug can cause trembling in the hands, anxiety, insomnia, nausea, headaches, dizziness, rectal suppository can provoke irritation.

The drug is incompatible with glucose, ascorbic acid, nitrogen-containing compounds.

Papaverin is an antispasmodic and is prescribed to reduce the tone of smooth muscles, as well as to reduce contractile muscle activity.

Dosage is prescribed by the doctor taking into account the age and condition of the patient.

Tablets are usually prescribed 3-4 times a day for 1 to 2 tablets, in the form of injections - 1-2 ml, rectally - 1 candle 2-3 times a day.

Aloe extract is a plant remedy, it is available in the form of injections, syrup, tablets, liquid solution for oral administration.

The drug has a laxative, antiseptic, choleretic, tonic effect. Improves intercellular exchange, tissue repair, increases the body's resistance. Against the backdrop of aloe treatment, allergic reactions, increased pressure, upset of the stool, redness of the skin are possible.

Aloe is prescribed daily for 1ml, the course of treatment is 1-2 months.

Pyracetam has long been used in restorative therapy after strokes.

The drug is not recommended for longer than 4 months, so unpleasant side effects are possible (irritability, nausea, nervousness, abdominal pain, sleep disturbance).

The drug is prescribed 1 tablet 3 times a day.

You can not use it simultaneously with psychotropic, cardiovascular drugs.

Paralysis of the hands after a stroke requires an integrated approach to treatment, in addition to drugs, gymnastics and support of relatives are necessary.

Alternative treatment

Treatment of paralysis of the hands with alternative means is aimed at removing the main symptoms.

When paralyzed, it is recommended to smear your hands with a mixture of lard and salt (per 100 g of saline 1 tbsp salt). After applying the product, the hand should be wrapped with a cotton cloth.

In the initial stages you can take infusion of herbs: take in equal parts oregano, mistletoe white, yarrow, valerian root, 1 tbsp. Mixture pour 200ml boiling water, insist 20-30 minutes, take half a cup after eating.

Paralysis of the hands is also treated with clay.

2 tbsp. Clay powder dissolve in 200 ml of water, soak the soft tissue with water and grind the paralyzed hands. To clay water, garlic cloves can be added (3 pieces on a fine grater). Wash hands at least 20 minutes every day.

Clay helps to reduce pain, draw toxins, normalize the work of cells.

[23], [24], [25]

Herbal Treatment

Paralysis of the hands with the help of herbs can be treated if the pathology is caused by diseases of the nervous system.

Below are some options for treating paralysis of limbs with medicinal infusions:

• infusion of shikshi - 2 ч.л. Herbs pour 200ml boiling water, wrap and insist for 2 hours, drink infusion 3 times a day for 1/3 cup before meals.
• the infusion of the initial - 1 tbsp. Herbs pour 200ml of boiling water, insist in a warm place for 2 hours and take several times a day for 1/3 cup.
• infusion of the root of the root (peony root) - 2 hl. Root pour 200 ml of boiling water, insist 2 hours, take 1/3 cup no more than 3 times a day.

• infusion of portulaca (used if the cause of paralysis is infection) - 1 tbsp. Herbs pour 200ml boiling water, insist 2 hours, drink 2-3 tablespoons. Before meals no more than 4 times a day.
• tincture of leaves of tobacco - 5 g of leaves pour 200 ml of boiling water, insist 1 hour, drink 1 tbsp. Not less than 3 times a day.

Homeopathy

Homeopathy is aimed at strengthening the body as a whole, which allows one to cope with this or that pathology at the expense of the body's own resources.

Homeopathic treatment of paralysis of the hands and paresis is prescribed by the doctor taking into account the condition of the patient, concomitant diseases, the causes that caused limb immobilization.

If paralysis of the hands is caused by diseases of the nervous system (stress, nervous overexertion, etc.), sedatives are prescribed to normalize the nervous system (Stress-gan, Passiflora, Homeostress).

After strokes, Lachezis, Glonoinum, Gelseeim, Veratrum Verida are used.

With obstetric paralysis - Hypericum, Kuprum Metalicum, Arnica, Gelzemium.

Stress-gan has a wide spectrum of action and normalizes the work of the nervous system, removes tension, reduces vegetative reactions under stress, unpleasant experiences, improves sleep.

Passionflower has a calming effect, improves the process of falling asleep, removes spasms and acts depressingly on the central nervous system.

Homeostress is prescribed for anxiety, restlessness, sleep disorders.

Lachezis in the staff of the team has a snake venom. The drug has a wide spectrum of action and is used for various diseases. The remedy refers to the "old" homeopathic preparations, due to the snake venom, Lachezis is referred to potent drugs, which must be taken only as prescribed by the doctor, not exceeding the dosage.

The drug is usually prescribed as part of a comprehensive treatment for inflammatory processes.

Hypericum has antidepressant, anxiolytic effect, eliminates anxiety, stress, improves mood.

Arnica influences tissue metabolism, the therapeutic effect is achieved through the combination of various herbs.

The product effectively calms, removes inflammation, stimulates the immune system, has a slight analgesic effect.

The dosage in each case is selected by the doctor depending on the condition, the age of the patient, the concomitant diseases,

Operative treatment

Operative treatment of paralysis of the hands is carried out if the pathology is caused by damage to the nerve endings.

Operations to restore the mobility of the hand is possible when there is at least one nerve left in the arm or shoulder.

During the operation, the surgeon connects the tiny nerve endings.

At the birth paralysis, the operation to restore the mobility of the hand is prescribed not earlier than six months after the birth of the child in the case when conservative therapy did not lead to positive results.

Microsurgical operations on the brachial plexus showed good effectiveness in the treatment of paralysis of the hands in infants, and also helped prevent disability.

Depending on the type and severity of the injury, the surgeon can choose one of the following types of surgery:

• neuroraphy - stitching of damaged nerve trunks (the operation is performed only if a little time has elapsed since the injury)
• neurolysis - release of transmitted nerve fibers
• Neuroectomy - replacing a damaged nerve with an autograft (assigned in the case of a neural tissue tumor or rupture of nerve fibers, resulting in the unification of the edges without tension is impossible).

All such operations are considered microsurgical and should be performed by a qualified specialist. During the operation, special optical instruments and instruments are used.

All patients after the operation need a recovery period, which can take a long time.

After the operation, the pain first passes, the sensitivity and motor functions are gradually restored. Forecasts for such treatment are almost always good.

Exercise therapy

Paralysis of the hands is a difficult condition, which requires a long recovery.

The main role during the treatment of hand paralysis is therapeutic gymnastics, which helps restore mobility, prevents hardening, deformation and contraction in the joints.

The complex of exercise therapy includes active and passive hand movements, as well as special massage.

During gymnastics, the hand should be in the correct position to prevent contraction.

Active exercises are selected taking into account the affected muscle group.

Passive movements are recommended to begin at the end of the first week, at first the lesson lasts no more than a few minutes.

Exercise is necessary at a slow pace, it is necessary to use all the joints in the paralyzed hand.

Passive exercises can include:

• leverage
• holding the brush in the specified position
• arm extension at the elbow
• turns and rotation of the forearm
• lifting a paralyzed hand with a healthy arm

Active gymnastics can include the following exercises:

• put an amazed hand on the table and try to move each finger (at first it may not work or you will be able to move just a few millimeters, but gradually you can achieve great results and restore the mobility of the hand)
• put your hand palm up on the table and try to connect your fingers into a fist (you can help with a healthy hand)
• alternately join the thumb to the others (it should look like the letter "O" or the ring), the hand can be kept on the weight or put on the table
• squeeze a small ball with your hand, in time you need to try to squeeze harder and repeat the maximum number of times (this exercise helps to restore strength in the hand)
• kick small paper balls with each finger of the paralyzed hand (the arm should lie on the table), the exercise helps to restore the mobility of the fingers.

Good results show therapeutic exercises in the pool or in a bath with warm water.

[26]

Massage with paralysis of hands

Massage is recommended before the therapeutic gymnastics, it helps improve blood circulation, promotes recovery of motor functions, prevents hardening of joints, constriction, stiffening of muscle fibers.

Also, after a massage, the pain is reduced (or completely), the patient's mood improves.

Paralysis of the hands often leads to muscle spasm (biceps, pectoral muscles), so in these cases, use gentle massage technique - light rubbing, stroking movements, shaking.

In areas with increased muscle tone (shoulder, triceps), deep massage techniques are used - active kneading, rubbing, stroking.

The massage of the brush starts from the back of the fingers, gradually turning to a brush, in this case energetic methods of massage are suitable.

On the palms of the muscles usually have an increased tone, so it is better to use light stroking.

Prevention

Paralysis of the hands can occur for various reasons, but the main preventive measure is a careful attitude to one's own health - timely treatment of infectious diseases, rejection of bad habits, minimizing stress and nervous shocks.

In addition, it is important to observe safety measures to avoid injuries.

Forecast

Paralysis of the hands with timely-started treatment usually has favorable predictions. With the right approach, the mobility of the hand sensitiveness and mobility in the paralyzed hand is gradually restored.

The recovery takes quite a long time - from several months to several years, but the desire and perseverance of the patient, as well as the support of relatives significantly improves the effect of treatment and contributes to a speedy recovery.

Paralysis of the hands is a serious disruption in the functioning of the body, which not only leads to loss of mobility of the hand, but also causes a number of psychological problems, therefore pathology requires complex treatment and support of others.