Paraparesis and Paraplegia

Paraparesis is weakness affecting both lower extremities, and paraplegia is paralysis of the lower extremities. Although lower extremity weakness can be caused by peripheral nerve or muscle disease, the terms paraparesis and paraplegia are usually reserved for manifestations of lesions of the corticospinal tracts, frequently at the spinal cord level. Sudden paraparesis is most often caused by spinal cord trauma, whereas developmental or slowly progressive paraparesis can be caused by cerebral palsy, congenital malformation of the spinal cord, or familial neurodegenerative diseases. Diagnosis is usually confirmed by magnetic resonance imaging scans of the brain and spinal cord and, in selected cases, by electromyography, vitamin or metal levels, antibodies titers, and genetic testing. Treatment depends on the diagnosis and ranges from vitamin replacement to spinal cord surgery. For chronic paraplegia, long-term treatment involves rehabilitation, psychological support, and prevention of complications such as infections.