Paula answers “I'd like to know why Martin Pistorius is...”

Sensible Psychology asked this question about Ghost Boy: My Miraculous Escape from a Life Locked Inside My Own Body:

I'd like to know why Martin Pistorius is still using a wheelchair when he's recovered use of his hands and feet, and why he is still mute when he's recovered use of his facial muscles? I think he owes it to his reading public to give some plausible medical explanation for this mysterious illness he is claiming. What do the British neurologists say about it?

Paula There is a big difference between an uninformed reader and a "medically plausible explanation". Please don't take offense, and I don't think you meant…moreThere is a big difference between an uninformed reader and a "medically plausible explanation". Please don't take offense, and I don't think you meant any, so I'll take a quick minute to write a couple lines I remember from my 800 page neuroscience text book - for neuro 101.

The precentral gyrus is your sensory area of the brain, post central gyrus is motor control, your cerebellum is PRIMARY, but not solely responsible for co-ordination, , brainstem bits are respobsible for arousal level- which has a lot to do with your posture and balance and tone (Martin has spasticity in many muscles). Its not like a light bulb, where if you have it plugged in it works or it don't; its the most complicated circuitry known to man kind, hundreds of times more complicated than top of the line computer server banks with hundreds of CPUs working at once. All of this information, the pull of gravity, the texture and shape of the floor, the position of every joint in your body- WHILE IN MOTION- has to be recieved, processed, coordinated into output, routed through the cerebellum and sent back to muscles that have to be quick enough, strong enough and have the endurance to respond.

Through dedicated therapy, he has regained a good deal of neuromuscular function- but not all and not at a high level, and not well co-ordinated. I bet if I strapped you down immobile for twenty years and then told you to walk, it would't be so easy- and you don't have a brain injury. Two months in traction is enough for most people to reqiure physical therapy to walk again after a traumatic injury to bone or muscle alone- it can all fall apart in 8 weeks...
MOST people in a wheelchair DO have some muscular control, whether they got there from a spinal cord injuy, MS, ALS, muscular dystropy, stroke etc.
Muscle strength, or coordination, endurance, perceptual sensation, tone or balance- and these things come from different parts of your brain AND your body. If you are lucky, they all work together beautifully, everything humming along at 100%- start burning out circuits and you could be screwed.
As for talking and facial muscles- you have 12 distinct cranial nerves that innervate the face and head and some of your neck. One nerve, the Facial, I think it's VII, innervates the muscles that let you smile and move your lips for speech, and some cheek muscles needed for eating/chewing. An entirely different nerve, with an entirely different pathway through the brain, trigeminal, or nerve V controls the muscles that open and close the jaw, (and some of your eye muscles) a third nerve, again, with its own connections and pathways innervates muscles in the tongue, XII which is one of the ONLY muscles in the body that is innervated by both sides of the brain, so weakness in nerve conduction on one side exacerbates difficulties because both sides need to work in tandem to maintain symmetry needed to speak. Perhaps Martin could try hard to learn how to speak, but should he? Should he come out drooling and mumbling and face that stigma when he can retain his dignity and articulation with an alternate communication device?

I took the time to write this up, becasue I think you just didn't know, but this is part of what Martn is talking bout in his book. I hope this was informative, and will help you to realize how INSANELY OFFENSIVE AND INSENSITIVE your initial comment was, and that you won't ever ever do it again, right? (less)

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Jannali Jones While the OP's questions could have been worded more thoughtfully, I think there is some merit in asking them because of the way the book is written. ...more
Sep 17, 2019 09:56PM · flag

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