Paralytic Strokes ( Hemiplegia)

Paralytic episodes leading to a partial or complete loss of sensation and muscular strength are common in the elderly. Paralysis occurs when a part of the brain tissues, often dealing with sensation and movement, is lost due to a stroke. Transient ischemic attacks often precede a stroke and manifest as a loss of sensation, function or strength in any part of the body. This usually recovers within 24 hours and is a warning that a stroke is likely soon. 50% of people who have a TIA will have a debilitating stroke within one year.

Injuries are a common pre-disposing cause for strokes. High-impact injuries can distort the skull, leading to blockage of the cerebrospinal fluid circulation as well as pressure on the underlying areas of the brain. This pressure constricts the circulation to that area, leading to cerebral ischemia. This area will then be the area most likely to cause a stroke to occur in later years. This is common after motor vehicle accidents or falls, which can pre-dispose to strokes many years later. Any person who sustains a head injury should be evaluated by a cranial osteopath and treated if necessary.

The natural recovery process occurs because the surrounding brain tissue is capable of taking over the function of the brain tissue that has been lost as a result of the stroke. The stem cells present in brain tissue also generate new brain cells. This recovery of the brain often occurs spontaneously over three to four months. Progress depends entirely upon the extent of natural recovery and is not influenced by physiotherapy. By this time, however, atrophy (loss due to non-use) of the muscles and nerves has occurred, which makes recovery poor and incomplete. As spontaneous recovery occurs, physiotherapy helps to strengthen and enhance voluntary movements. Its efficacy is, therefore, restricted because it wholly depends on a random event, the natural recovery process.

Voluntary movement consists of a chain of events involving four discrete organs: the brain, the nerves that carry the impulses from the brain to the appropriate muscles, the muscles that carry out the required movement, and the sensory nerves that provide feedback movements performed to the brain. Each of these four segments requires attention, as the damage to the brain invariably leads to atrophy of the other segments of the chain. Hence, treatment must be directed towards ensuring the integrity of all four chain segments. The commencement of treatment by acupuncture as early as possible typically leads to a dramatic recovery to the extent of 80% to 100%.

Electro-acupuncture is an extraordinarily effective treatment modality for augmenting the natural recovery process and preventing muscle and nerve atrophy. Treatment in the initial few days after a stroke leads to a reduction in the oedema and the inflammation of the brain. This improves the state of consciousness and clarity of the individual and can be commenced even in an unconscious patient in a coma. Simultaneous treatment of the muscles and neural pathways ensures they stay alive and valuable. The various areas of the brain are reflected on the scalp, and stimulation of the appropriate regions of the scalp stimulates the corresponding brain areas. Peripherally, the therapy leads to the sensory awakening of the muscles, and by enabling opposing groups of muscles, it provides a quick recovery and a return to normal function.

Pulsed electromagnetic frequency treatment restores the potential difference between the inside and outside of the cell to the normal range. In damaged cells, this can be as low as from -20 to -30mv, compared to the normal range of -60mv. This improves the ability of the nerves to carry the electrical impulses necessary for sensation and movement and allows more muscular muscle contractions to take place, thus speeding up the recovery process. The active treatment period commences as soon after the stroke as possible and lasts about two to six months.

The subsequent rehabilitation period involves physiotherapy, active exercises, and occasional treatment to supplement difficult recovery areas, emphasising voluntary movement. Physiotherapy is helpful in that passive movements prevent the occurrence of contractures (fibrosis) around a joint, which will later hamper joint movement. It also aids in lessening the spasticity that follows a few weeks after the paralytic episode. Conventional treatment, including physiotherapy, could be more satisfactory in ensuring a complete recovery.

During the recovery process, it is essential to encourage the patient to achieve new goals. It is also important to educate the patient and his family that a complete recovery is possible and attainable with the appropriate effort at the right time.