Issue link: https://www.massageandbodyworkdigital.com/i/72195
PATHOLOGY PERSPECTIVES Nerve Injury Terminology Familiarity with the vocabulary of nervous system damage can make it much easier to talk shop with clients and doctors. Flaccid paralysis. A sign of damage to lower motor neurons (i.e., the ones that leave the brain and spinal cord to supply muscles and glands). Paralysis. From the Greek for loosening, the loss of any function controlled by the nervous system—motor or sensory supply. Paresis. Partial or incomplete paralysis. Paresthesia. Any abnormal sensation, particularly the tingling, burning and prickling feelings associated with "pins and needles." Spastic paralysis. Damage to upper motor neurons (i.e., neurons that are completely located in the brain or spinal cord. TYPES OF SPASTIC PARALYSIS: Diplegia. A symmetrical paralysis of upper or lower extremities resulting from injuries to the cerebrum. Hemiplegia. One vertical half (or hemisphere) of the body has been affected. Paraplegia. The bottom half of the body, or some part of it, has been affected. Tetraplegia or quadriplegia. The body has been affected from the neck down. of the body becomes progressively weaker and more disabled. This observation led to a treatment strategy for CNS injuries that focuses on adaptation: teaching the person how to accomplish daily tasks with his or her strongest limbs; providing assistive devices to compensate for loss of strength and function; and changing the living environment as much as possible to keep challenges within a realistic spectrum for the patient's new limitations. This approach allows many people to live independently after CNS injuries, but it has created an unexpected phenomenon: "learned non-use." In other words, the injured person, who has lost some nerve supply to his or her legs, or to one side of the body, essentially gives up on that area ever being able to function again. The proprioceptors relay information that their limitation is great and getting greater. The weakened limb(s) degenerate continually, taking the form of deconditioning, loss of muscle mass, and irreversible contractures. While some function loss is plainly inevitable, it seems clear that some is a self-fulfilling prophecy: the body senses a limitation and accepts that limitation as a done deal; thus, the limitation increases and progresses. A NEW CNS INJURY PARADIGM Beginning in the 1930s, neurobiologists and neurochemists made some unexpected discoveries about the CNS: damaged neurons in the brain and spinal cord are far more adaptable to external influences than previously thought. This recuperative capacity has been termed neuroplasticity. It turns out that even a mature brain can grow new neurons or establish new connections between neurons where none had been seen 114 massage & bodywork september/october 2008