Paresis the inexorable muscle wastage of multiple sclerosis despite exercise and activity.

Paresis is the medical term for partial or mild paralysis, often described as muscle weakness. In MS it is usually caused by nerve damage as a result of demyelination of the nerve fibres.

The nerve damage may be caused by lesions in the spine, cerebellum or brainstem. This damage and resultant impairment of the motor nerve pathways brings about the perceived muscle weakness. It should not be confused with ataxia which is the inability to coordinate the muscle movements.

This muscle weakness can lead to a lack of exercise which in turn can bring about loss of muscle tone or atrophy.

Paresis in Multiple Sclerosis (MS)

Depending upon the areas affected by the paresis, the terminology varies:

  • monoparesis – affects one or other leg
  • paraparesis – affects both legs
  • hemiparesis – affects one half of the body
  • quadraparesis – affects all four limbs

Braces, Canes (walking sticks), walkers, scooters, wheelchairs, or other assistive devices can help the patient remain mobile.

I suffer from quadraparesis although the paresis in my arms is very mild so it may be termed paraparesis. I do manage to exercise, very gently, to help avoid any muscle atrophy. I have found swimming to be very beneficial, although don’t ask me to walk when I get out of the pool.

paresis
Old Wheelchair

It has been mooted that I should get out and exercise more. A logical response but one that can be counter-productive. The paresis is a neurological problem not a muscular problem. Exercise will build and maintain muscle tone and strength in a normal individual. In MS this exercise overworks the nerves resulting in further degradation in their performance.

Using an electrical analogy, I am, was, an electronics engineer; If an electrical cable is carrying a high current it will overheat which reduces its conductivity. If the overheating continues, the insulation breaks down and the connection fails.

From this it can be seen why physical exercise, for someone with Multiple Sclerosis, can be detrimental. Its a catch 22 situation. If you try to exercise your illness will worsen, if you don’t exercise you will lose muscle tone and ultimately mobility.

My muscle wastage is most noticeable in my left arm. I have, for a number of months, been exercising with 3kg dumbbells. Doing simple arm curls to try and build muscle mass in my biceps. This regime is working very well for my right arm, but my left arm is still puny despite double the repetitions I do for the right arm.

References:

Multiple Sclerosis Encyclopaedia
Medline Plus

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