From the Guidelines
Paresis, or partial or complete loss of motor function in limbs, is primarily caused by neurological damage, vascular insufficiency, or muscle weakness, with stroke being a leading cause, as evidenced by studies such as 1 and 1.
Causes of Paresis
The causes of paresis can be multifaceted, including:
- Neurological conditions like stroke, spinal cord injury, or peripheral nerve damage, which disrupt the normal communication between the brain and limbs, resulting in paralysis or weakness.
- Vascular problems such as peripheral artery disease, which reduce blood flow to the extremities, causing pain and limiting function.
- Muscle weakness due to prolonged immobilization, muscle atrophy, or certain medication side effects.
Prevention and Treatment Strategies
Prevention strategies include:
- Early mobilization after injury or surgery
- Regular physical activity
- Proper nutrition to maintain muscle mass
- Prompt treatment of underlying medical conditions Physical therapy plays a crucial role in restoring function through targeted exercises that rebuild strength, improve range of motion, and retrain movement patterns, as recommended by guidelines such as 1 and 1.
Recent Guidelines and Recommendations
Recent guidelines, such as the 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease 1, emphasize the importance of early diagnosis and treatment of peripheral artery disease to prevent complications such as paresis. Similarly, the 2024 ESC guidelines for the management of peripheral arterial and aortic diseases 1 recommend a multidisciplinary approach to the management of patients with severe limb trauma, including early fasciotomy and revascularization to prevent paresis and other complications.
From the FDA Drug Label
Nervous System: Frequent: depression, anxiety, paresthesia; Infrequent: tremor, emotional lability, convulsion, paralysis, thinking abnormal, vertigo, abnormal dreams, agitation, depersonalization, euphoria, migraine, stupor, dysautonomia, neuralgia; Rare: dementia, hemiplegia, neuropathy.
The cause of paresis (partial or complete loss of motor function) in limbs is not directly stated in the provided drug labels. However, paralysis is listed as an infrequent adverse event in the nervous system category for tizanidine 2, and hemiplegia (paralysis of one side of the body) is listed as a rare adverse event in the same category.
- Paralysis and hemiplegia can be related to paresis, but the exact cause of paresis is not specified in the labels.
- The labels do not provide a clear answer to the question of what causes paresis in limbs.
From the Research
Causes of Paresis in Limbs
Paresis, or the partial or complete loss of motor function, in limbs can be caused by various factors. Some of the possible causes include:
- Spinal cord injuries, which can damage the spinal cord and affect the transmission of signals between the brain and the limbs 3
- Stroke, which can cause damage to the brain and lead to impairments in motor function, including paresis 4, 5, 6
- Peripheral neuropathy, which can cause damage to the nerves in the limbs and lead to paresis 7
- Muscle weakness, which can be caused by a variety of factors, including muscle atrophy, nerve damage, and neurological disorders 6
Mechanisms of Paresis
The mechanisms of paresis can be complex and involve multiple factors, including:
- Physiological changes in the paretic muscles and their motor units 6
- Abnormal muscle activation patterns, which can lead to reduced muscle force generation and abnormal gait patterns 6
- Increased passive tone, which can impede agonist and antagonist muscle torque generation 6
- Abnormal co-activation of opposing lower limb muscles, which can contribute to joint stiffness and postural stability 6
- Abnormal timing of muscle activation, which can yield reduced muscle work output and reduced limb function 6
Effects of Paresis on Daily Life
Paresis can have a significant impact on daily life, affecting an individual's ability to perform activities of daily living, such as eating, bladder management, and transfers 3. Rehabilitation strategies, such as reinnervation plans and behavioral therapies, can help to improve motor function and independence in individuals with paresis 3, 5.