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Does paralysis fully recover and how long does it take?

Nov 2013
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Practicing since : 1994
Answered : 5277 Questions
My Sister, 50 years,was operated at Artemis Health Institute, Gurgaon for Intradural Extramedullary Tumor (around 12.4 mmx 6.6x9.6 mm) below C3 and C4 Cervical Vertebrae on 03/12/2013 and surgery went on smoothly from 0830 to 1130 hrs and she was alright upto 1530 hrs and her limbs were working properly, but at 1730 hrs suddenly her legs got paralysed and after MRI doctors told that there is unexplained swelling in medulla and at 0030 hrs after that she started having breathing problem and was immediately put on ventilator. Now her hands and legs are paralysed and she is still (54 hrs after the surgery) on ventilator. We were told that she would be given IVIG if improvement in breathing does not start by tomorrow. What could be the best possible line of treatment and what's the best and worst that we can expect? As per the MRI done 06/12/2013 morning, the swelling of medulla has subsided but it is still there in the operated region. She is still on ventilator but we are told that IVIG is not being started due to swelling of medulla improving and steroids are being contd. for further 24 hrs to watch the condition. On 07/12/2013, patient is stable on ventilator, there is no improvement in breathing which is still th ventilator even after 72 hrs of steroid therapy (around 6grms total. Dose given) . Dr is suggesting starting IVIG. after review of MRI report of tomorrow morning if breathing does not improve. IVIG given for 5 days (36 gms per day) Condition stable in the sense that passing urine and stool, feeding th nasal tube with liquids, semi soilds, conscious and recognises and responds, moves neck and tongue but rest of the body paralysed, still on ventilator but in the last 4 days switched to CP-AP mode intermittently. No fever for last 3 days. Kindly guide how long it will take for getting off the ventilator? Will she recover fully from the current paralysed condition? How long it may take for her to recover? regards
Posted Mon, 6 Jan 2014 in Brain and Spine
Answered by Dr. Sudhir Kumar 3 days later
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for posting your query. It is unfortunate that your sister has suffered from paralysis of both arms and legs, after surgery for cervical cord tumor. The current condition is related to the swelling in the cervical spinal cord, which in turn is related to trauma/bleeding due to surgery. Swelling in medulla could be a reaction, called as demyelination (to viral infection or stress of surgery). Treatment so far, has been along the correct lines (methylprednisolone and IV immunoglobulins). Mechanical ventilation would be needed until her breathing improves. We expect a gradual improvement. The first priority is improvement in her breathing. Tracheostomy (surgical hole in the wind pipe) may be needed, if the need for ventilator is prolonged. After she is removed from ventilator, there would be slow improvement in the motor power of arms and legs, which may take a few weeks to few months. Physiotherapy should be continued. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: My blog:
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