Paraplegia
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Paraplegia

(Paralysis; Loss of Movement)

Pronounced: Pehr-ah-PLEE-jah

En Español (Spanish Version)

Definition

Paraplegia is the term used to describe the body's loss of movement and/or feeling as a result of damage or trauma to the nervous system. The condition involves complete or partial paralysis of the legs and/or the trunk of the body, but not the arms. The location of the paralysis and the extent of the paralysis depend on the severity and location of the damage to the nervous system.

Paraplegia describes paralysis only on the lower half of the body. In patients who suffer from paralysis of the entire body, including arms, the condition is called quadriplegia .

Depending on the location and severity of the damage to the nervous system, some types of paraplegia may be reversed, and patients may resume some function. Many types of paraplegia are permanent, though.

Paraplegia

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© 2008 Nucleus Medical Art, Inc.

Causes

Injury to the nervous system is the most common cause of paraplegia. Common injuries and other causes include:

  • Broken neck
  • Broken back
  • Stroke
  • Spinal cord injury
  • Genetic disorder (hereditary spastic paraplegia)
  • Congenital (present at birth)
  • Infection
  • Autoimmune diseases
  • Tumor
  • Syrinx

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Paraplegia is typically the result of an unanticipated accident. People who participate in high-risk or high-contact sports or drive recklessly may be at a greater risk of suffering an injury that could cause this condition.

Symptoms

Symptoms will depend on how much of the spinal cord is involved. By definition, paraplegia only occurs in people who have lower spinal cord involvement. Symptoms include:

  • Loss of movement or muscle control in the legs, feet, toes, or trunk
  • Loss of sensation in the legs, feet, toes, or trunk
  • Tingling in the legs, feet, toes, or trunk
  • Loss of bowel and bladder control
  • Sexual dysfunction

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Most often, neurosurgeons, orthopedists and neurologists are involved in diagnosis after a paralytic injury has occurred.

Tests may include the following:

  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body, in this case the head or spine
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body, in this case the head or spine
  • Myelography —a type of x-ray that uses an injection of a contrast medium to view the spinal cord
  • Blood tests, including complete blood count (CBC)
  • Evoked potential nerve tests
  • Lumbar puncture to obtain spinal fluid for diagnostic testing

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Emergency Medical Treatment

If an injury has been sustained that causes paraplegia, emergency medical treatment is needed to prevent further damage to the nervous system. Once an evaluation has been performed and the severity of the damage has been determined, a doctor will determine what therapies are needed to prevent additional injury and maximize recovery. Steroids may be used to minimize the swelling of the spinal cord if it has been injured. Surgery may be performed to help stabilize the spine. If a tumor is causing compression of the spinal cord surgery to remove it may be of benefit. Radiation therapy is another possible treatment which may be considered.

Therapy and Rehabilitation

In most patients, physical therapy and rehabilitation may help restore muscle function. Occupational and speech therapy may also be beneficial.

Prevention

Although paraplegia is most often caused by injury or accident, the chance of injury resulting in paraplegia may be lessened by paying careful attention to environmental factors. Using safety equipment when playing sports and wearing seatbelts when driving will help reduce the chance that an accident will cause serious injury. Avoidance of risk taking activities, such driving while under the influence or driving when tired, will also reduce the likelihood of accidents that can cause paraplegia.

RESOURCES:

Christopher and Dana Reeve Foundation
http://www.christopherreeve.org/

Spastic Paraplegia Foundation
http://www.sp-foundation.org/

CANADIAN RESOURCES:

BC Health Guide
http://bchealthguide.org/kbaltindex.asp

Canadian Paraplegic Association
http://www.canparaplegic.org/en/

References:

Alisky JM, Nogo A. Protein neutralisation and motor cortex computer implants: a future hope for spinal cord injury [review]. Singapore Med J. 2007;48:596-597.

Faden AI, Stoica B. Neuroprotection: challenges and opportunities [review]. Arch Neurol. 2007;64:794-800.

Kruszewski SP, Shane JA. Pregabalin in central neuropathic pain associated with spinal cord injury: a placebo-controlled trial. Neurology. 2007;68:2158-2159.

Muscle function loss. Medline Plus Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/003190.htm . Accessed July 6, 2007.

Nervous system: spinal cord injury. Mayo Clinic website. Available at: http://mayoclinic.com/health/spinal-cord-injury/DS00460/DSECTION=1 . Accessed July 6, 2007.

NINDS spinal cord injury information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/sci/sci.htm . Accessed July 6, 2007.

Penas-Prado M, Loghin ME. Spinal cord compression in cancer patients: review of diagnosis and treatment. Curr. Oncol. Rep . 2008;10:78-85.

Sharma HS. Neurotrophic factors in combination: a possible new therapeutic strategy to influence pathophysiology of spinal cord injury and repair mechanisms [review]. Curr Pharm Des. 2007;13:1841-1874.



Last reviewed April 2008 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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