Single paralysis, paralysis in one limb is called monoplegia.Monoplegia can be caused by peripheral neuropathy and central neuropathy.The lesions may be located in the anterior horn of spinal cord, anterior root, nerve plexus and peripheral nerves.The acute onset is seen in trauma, and the gradual onset is seen in the compression of nerve plexus and nerve root, such as tumor and cervical rib compression.
Clinically, if the focus of monoplegia is located in the cortex or subcortical area, it can be central; if the focus is located in the anterior horn of the spinal cord, the anterior root, and the peripheral nerve, it can be peripheral.
Disease Overview
Announce
edit
Paralysis of one limb is called monoplegia.Monoplegia can be caused by peripheral neuropathy and central neuropathy.The lesions may be located in the anterior horn of spinal cord, anterior root, nerve plexus and peripheral nerves.
Etiology and pathology
Announce
edit
The acute onset is seen in trauma, and the gradual onset is seen in the compression of nerve plexus and nerve root, such as tumor and cervical rib compression.
Diagnosis and differentiation
Announce
edit
（1） Monoplegia caused by peripheral neuropathy monoplegia caused by peripheral neuropathy is characterized by motor neuron paralysis, that is, flaccid paralysis.Muscular atrophyIt is obvious that the tendon reflex is reduced or disappeared, and there are symptoms and signs of sensory disorder, pain, vascular movement disorder and nutritional disorder.
1. The lesion of anterior root or anterior horn cells is segmental.The lesion of simple anterior horn has no sensory disturbance. The acute case is acute gray matter, and the chronic case is progressive spinal muscular atrophy. Muscle atrophy is more obvious than paralysis, and there is muscle bundle fibrillation.Similar chronic paralysis may occur in syringomyelia and anterior horn, but there are segmental pain, loss of temperature sense and sensory separation of tactile presence.Anterior root damage is often accompanied by root pain and segmental sensory disturbance due to simultaneous posterior root damage.The common causes of radiculopathy are tumors, inflammation, tuberculosis, trauma and herniation of intervertebral disc in the spinal meninges and spine.
2. Neuroplexy disease is paralysis of the whole upper or lower limbs with sensory disturbance.When the brachial plexus is damaged, the muscles of the whole upper limb are flaccid paralysis, and various senses below the arm disappear, which can be caused by brachial plexus neuritis, trauma, tumor compression, etc.The paralysis and atrophy of the shoulder muscles at the proximal end of the unilateral upper limb and the sensory disturbance at the upper lateral side belong to the upper trunk injury of the brachial plexus, which can be caused by birth injury, puncture or fall injury.The injury of the lower trunk of the brachial plexus is the ulnar sensory loss caused by the paralysis and atrophy of the small muscles of the hand in Nanchang and the inability of the wrist and little finger to flex. It can also have Horner's syndrome, which can be caused by lung apex tumors, clavicle fractures, neck ribs, humeral head fractures or dislocations, sudden upward traction of the arm, excessive extension of the shoulder joint, etc.When the lumbar plexus is damaged, it may be manifested as paralysis and sensory loss of the whole lower limbs, which may be caused by spinal tuberculosis or dislocation, perforating injury, psoas abscess, pelvic tumor compression, etc.
3. When the peripheral nerve is damaged, the paralysis of the muscle or muscle group innervated by the nerve and the sensory decline or disappearance of its distribution range, the corresponding tendon reflex disappears, and long-term serious damage often atrophy.It is mostly caused by local trauma, fracture, detachment, compression, ischemia, etc.
（2） Monoplegic myelopathy caused by myelopathy usually occursparaplegiaHowever, if the damage to the half of the spinal cord is located in the thoracic spinal cord, it can produce upper motor neuron monoplegia and deep sensory disturbance of the same lower limb, and pain and temperature disturbance of the opposite lower limb, which is called hemisection syndrome.It can be caused by spinal cord tumor, trauma, inflammation, multiple sclerosis, etc.
（3） Monoplegia caused by cerebral lesions in the motor area of the cortex can lead to upper motor neuron monoplegia, and if the lesions are located in the lower part of the central anterior gyrus, upper limbs can appearSpastic paralysis, the distal end of the upper limb is the most important, and muscular atrophy is rare.If the lesion is located in the upper part of the anterior central gyrus, spastic monoplegia of the lower limbs will occur.Such monoplegia may be accompanied by sensory disturbance if the lesion involves the posterior central gyrus at the same time.In most cases, upper limb paralysis is accompanied by motor aphasia and central facial paralysis.The etiology was mainly tumor, vascular, inflammation and trauma.
