SUDDENLY PARALYZED!

WHEN OUR BODIES REFUSE TO OBEY OUR COMMANDS

It happens without warning: Paralysis comes on suddenly and seemingly out of nowhere—as you’re waking up, going for a walk, or returning from a night out. Researchers have been trying to get to the bottom of these mysterious cases of sudden paralysis to explain what is taking place in the body when they occur…

What a nightmare: Tim is dreaming he’s being tortured, with no end in sight and no way out. So imagine the 25-year-old’s sense of utter relief when he opens his eyes and sees his bedroom’s familiar ceiling. However his relief at returning to reality doesn’t last for long— just three seconds, to be precise. Because as Tim attempts to roll over toward his sleeping girlfriend, he realizes he can’t. His limbs will not obey his brain, his arms and legs seem to be pinned to the bed, and his head feels as if it weighs a ton. Tim is paralyzed. Only his eyes are able to dart back and forth. He can feel his heart beating faster with each passing second. He wants to scream, but he can’t open his mouth…

The human brain contains around 100 billion neurons, each of which can fire up to 1,000 times a second. This system governs our perceptions, the tension in our muscles, our sense of direction—and it all takes place at the subconscious level for the most part. What many of us don’t realize— until it gets experienced—is that this incredibly complex network can shut down from one moment to the next, robbing us of control over our bodies. Without an external influence or any sort of warning, we may suffer instant paralysis, and it could happen at any time: When we’re walking or dancing or—as in Tim’s case—just waking up. Long recognized in medical circles, these cases nevertheless continue to puzzle neurologists. Rarely do we hear of this peculiar phenomenon— a condition that’s not only impossible to predict but also difficult to treat. On the following pages, researchers explain some of the more mysterious instances of sudden paralysis and their possible causes.

SLEEP PARALYSIS: CAN A NIGHTMARE PARALYZE MY MUSCLES?

Tim’s forehead is beaded with sweat. After having lain helplessly in bed for three seemingly endless minutes, he twitches. And suddenly he can move: first his fingers, then his arms and legs. Tim has regained control of his body. But ever since the incident occurred, he has panicked at the thought that it could happen again. And he’s not the only one. It may sound like a nightmare within a nightmare, but it is actually a fairly widespread phenomenon. Every night millions of people wake up to find themselves paralyzed for several minutes. Thousands of victims have shared their experiences on Internet forums. “Sleep paralysis” is the name doctors give this type of disturbance, which leaves no lasting damage but can cause great anxiety to sufferers. But what triggers such an episode of sudden short-term paralysis?

Sleep expert Ryan Hurd explains that sleep paralysis is a side effect of our body’s protective mechanisms. While we dream, the brain suppresses its locomotor region. Otherwise we’d physically act out every movement we dream about, and we could even injure ourselves. The problem: If we wake up too quickly from a dream (as often happens with nightmares), the body may skip the phase of gradual waking up that would normally follow deep sleep. As a result it can happen that we are awake, but our locomotor system is still disabled. So the motor cortex is in offline mode and unable to transmit commands to the muscles of our limbs. The result: body-wide paralysis in a fully conscious state, as in the case of Tim. However the young man was nonetheless lucky, for the American Academy of Sleep Medicine (AASM) reports that many victims of sleep paralysis also suffer from severe dreamlike hallucinations.

If you find yourself in such a situation, researchers suggest the following:

1. Never try to fight the paralysis; try

to relax instead.

2. Breathe deeply and consciously.

3. Calm down and tell yourself: “I’m experiencing sleep paralysis. I am not in danger. It won’t last.” 4. When you can move again, eat something or drink a glass of milk.

Says Hurd: “This kind of immobility happens every night as a natural side

effect of dreaming sleep and is totally harmless. It’s when we become aware of it that the trouble starts.”

SHOCK PARALYSIS: HOW CAN PANIC PREVENT BODILY MOVEMENT?

Fight or flight? Whether it’s a fire in the home, a robbery, a terror incident, or an attack by a ferocious animal: Our instinctive response to a threatening situation is to fight or to flee. At least, that’s what you’ll find on the pages of behavioral psychology textbooks. But in reality there is yet another possible reaction to an emergency situation— one that has scarcely been explored and is only gradually attracting the attention of the scientific community: the freeze response. In a study that was conducted by psychologist John Leach during his time at Lancaster University in the UK, around 10% of subjects reacted to a dire threat by freezing. Though they recognized the danger—saw the flames, or heard the shots—and felt their heart pounding, they remained petrified for precious seconds. They found that they simply could not budge. This type of sudden total-body paralysis could potentially cost a person his life in an extreme situation. “Many witnesses attest that disaster victims often perish despite reasonable possibilities for escaping because they’ll fail to act during the initial moments,” says Leach. But how can panic paralyze your muscles?

Neurologists at England’s University of Bristol have discovered a pathway in the brain that appears to regulate the freeze response. Our perception of danger gets registered within the periaqueductal gray (PAG) region of the brain, which can trigger reflexive responses to either fight, take flight, or freeze. The researchers identified a specific neural circuit leading from the PAG to the part of the cerebellum that causes a body to freeze in place. The result: sudden paralysis. It is still unclear why only about 1 person out of 10 responds in this manner while

EVERY NIGHT MILLIONS OF PEOPLE WAKE UP AND FIND THEY CAN’T MOVE.

most people who are caught in a lifethreatening situation react by fighting or fleeing. The same neural pathways are involved in fear-evoked behavior in most mammals. So animal studies could help neuroscientists establish how they work, which might lead to new treatments for human emotional disorders. Unfortunately, for many such victims the freeze mode is only terminated by a painful stimulus: the impact of a bullet, a fire burning the skin—i.e., when it’s too late to react.

But sudden paralysis doesn’t just occur in extreme situations or when we’re waking up: It can be triggered by a series of mysterious phenomena, and the more unexpectedly paralysis occurs, the more frightening it is.

GUILLAIN-BARRÉ SYNDROME: WHY WON’T MY LEGS BEHAVE?

The problem often starts with tingling or prickling in your fingers and toes. After going for a long walk in Seattle, German newspaper correspondent Friedemann Diederichs felt a little bit wobbly on his legs, but nothing more. Having been warned back in Germany about the possibility of diabetes, the 55-year-old assumed it had to do with his blood sugar levels. But he was sadly mistaken…

Just 24 hours later Diederichs lay motionless on the floor of his hotel room, unable to get up. He’d suddenly collapsed and lost control of his limbs: He was almost completely paralyzed. Fifteen minutes later an ambulance came to take him to a Seattle hospital, where doctors performed a battery of tests to check his blood, reflexes, and heart. The diagnosis: Diederichs had Guillain-barré Syndrome (GBS). It’s a rare autoimmune disorder that causes the immune system to attack the nerves, and it was named for the two French physicians who had first detected it. GBS is often preceded by an infectious illness, such as the stomach flu or a respiratory infection, but the exact cause remains unknown. When illness damages the protective covering (myelin sheath) of the nerves, they are no longer able to transmit signals to the brain, which can cause weakness, numbness, or paralysis. An estimated 3,000 to 6,000 people develop GBS in the United States each year—about one or two cases per 100,000 individuals. Most people fully recover, but in some instances people have died of this disorder, usually due to breathing difficulties. Diederichs was lucky that in his case doctors made the correct diagnosis and began his therapy immediately.

NEUROLOGISTS HAVE DISCOVERED A NEW NEURAL PATHWAY.

ANYONE WHO THINKS SUDDEN PARALYSIS IS ONLY CAUSED BY EXTERNAL INFLUENCES SHOULD THINK AGAIN. FOR THE BODY ITSELF CAN TRIGGER THE CONDITION—OFTEN WITHOUT WARNING.

Although there is no cure for GBS, the treatments include intravenous immunoglobulin and plasma exchange (plasmapheresis) in addition to other measures for relieving the symptoms. After two weeks in intensive care and another six months of rehabilitation, Diederichs could finally go home. Today only his slightly shuffling gait reminds him of the mysterious illness that he could not have seen coming. Sudden paralysis is an experience that a young man named Daniel also endured. And by way of contrast with Diederichs, who’d been warned about diabetes, Daniel never suspected that there was anything wrong with him…

CONVERSION DISORDER: COULD A TRAUMA PARALYZE MY BODY?

Nineteen-year-old Daniel was leaving the nightclub in the early hours of the morning when he simply collapsed. Suddenly he had no sensation in his arms and legs, but since he had taken no drugs and drank only a little bit of alcohol, he was completely conscious and aware. In a panic, Daniel tried to move but his body simply refused to obey him in the minutes that followed. He would remain in that condition for hours, days, months, and finally more than a year. But how was it possible that a healthy, athletic teenager had suddenly become paralyzed?

Not long after the abrupt collapse Daniel was brought to the emergency room, where doctors began a series of comprehensive tests to detect the problem. They checked his blood and cerebrospinal fluid and performed an MRI. All the results indicated that the patient was in perfect physical health. It would be a year before Daniel was examined by a team of psychiatrists. After several sessions with the young man, they were able to determine the reason for this mysterious condition: Daniel was afflicted by a neurological condition called conversion disorder.

Those who suffer from this disorder are unwittingly carrying around some trauma that they’ve been repressing for years—till the time bomb explodes. According to Freudian psychology, an unbearable psychological conflict can lead to the conversion of the mental suffering into physical symptoms. In Daniel’s case, it paralyzed his body. The psychiatrists discovered that he had been under extreme pressure to perform well at his school, and they believe the stress detonated his time bomb. Although Daniel’s family was initially skeptical that his illness had a psychological basis, several months of therapy did produce the desired result: Daniel could once again freely move his arms and legs. Today the young man has almost fully recovered (and he still goes out to the nightclub).

MANY PEOPLE ARE UNWITTINGLY WALKING AROUND WITH A TIME BOMB INSIDE THEIR BODY. WHAT HAPPENS IF IT GOES OFF?