Quadriplegia and Paraplegia
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Quadriplegia and Paraplegia

Pronounced: KWOD-ra-plee-gia, PA-ra-plee-gia

En Español (Spanish Version)

Definition

Injury or disease to a person’s nervous system can affect the ability to move a particular part of the body. This reduced motor ability is called paralysis. Paraplegia is paralysis of both legs or both arms. Quadriplegia, sometimes called tetraplegia, is paralysis of both legs and both arms.

Causes

Quadriplegia and paraplegia are most often caused by spinal cord injuries but can also be caused by nerve diseases such as multiple sclerosis and amyotrophic lateral sclerosis ( Lou Gehrig’s Disease ). Most spinal cord injuries are caused by accidents (car crashes, falls, and sports injuries).

The location, along the spine, where the injury occurs will determine the presence of quadriplegia versus paraplegia. Damage to the spinal cord at the base of the skull or neck leads to quadriplegia. Damage below the neck results in paraplegia.

Quadriplegia

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© 2008 Nucleus Medical Art, Inc.

Paraplegia

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© 2008 Nucleus Medical Art, Inc.

Risk Factors

A risk factor is something that increases one’s chance of developing a medical condition or getting injured. Risk factors for quadriplegia and paraplegia include:

  • Jobs or sports activities that increase your chances of spinal injury. High-risk sports include football, rugby, wrestling, gymnastics, diving, surfing, ice hockey, and downhill skiing.
  • Family history of certain inheritable nerve diseases

Symptoms

Paralysis due to spinal cord injuries may be total or partial, depending on how much of the spinal cord is damaged. In addition to paralysis of the arms and/or legs, patient may also suffer from incontinence (bladder or bowel), sexual dysfunction, trouble breathing, or difficulty sitting upright depending on the level of the damage.

Inactivity due to paraplegia and quadriplegia can cause additional problems like bed sores, spastic limbs, weakened bones and chronic pain. People with paraplegia and quadriplegia may also become depressed because of social isolation, lack of emotional support, and increased dependence on others.

Diagnosis

Diagnosis of people with paraplegia and quadriplegia involves finding out where and how badly the brain and spinal cord are damaged. To do this, doctors will likely run the following tests:

  • CT scan (computed tomography)—A procedure that makes detailed computer pictures of the brain and spinal cord.
  • MRI (magnetic resonance imaging)—A procedure that uses a magnet, radio waves, and a computer to make detailed pictures of the brain and spinal cord.
  • Myelography (rarely used)—A procedure that involves injecting a special dye into a person’s spinal canal. X-rays or CT scans can then be used to identify the damaged areas of the spine.
  • Electromyography/Nerve Conduction Velocity (EMG/NCV)—a procedure using electrical stimuli to evaluate the condition of the nerves as well a needle probe to evaluate the muscles. This is used most often in situations where the cause of the injury to the spinal cord is not due to trauma.
  • Somatosensory Evoked Potentials (SSEPs)—a test less often performed to evaluate the conduction of the nerves in the spinal cord.

If a neurologic disease is suspected, a lumbar puncture may be performed to obtain a sample of cerebrospinal fluid, which bathes the spinal cord and interior of the brain.

Treatment

Immediate treatment of spinal cord injuries includes bracing the bony spine to keep it from moving and further injuring the spinal cord. Steroid (e.g. cortisone) and other medications may be used to lessen damage to nerves and adjacent tissues.

Recovery and rehabilitation usually begins in the acute care hospital setting. A combination of medications, surgery, intensive physical therapy, and counseling are employed depending on the cause and extent of the quadriplegia and paraplegia. During this time, patients are fitted for mobility aids, often including wheelchairs. For most people, the majority of recovery happens within the first year.

Prevention

The following measures are recommended by safety experts to reduce your chance of getting a spinal cord injury.

  • Drive safely. Motor vehicle accidents are the leading cause of spinal cord injuries. Wear a seat belt every time you drive, and make sure your children wear a seat belt or are in a child safety seat. Don't drive while intoxicated.
  • Be safe with firearms. Lock up guns and ammunition in a safe place to prevent accidental shootings. Store guns and ammunition separately in locked containers.
  • Take preventive measures to avoid falls. Use a stool or stepladder to reach high places. Add handrails along stairways. Place nonslip mats in your bathroom, shower, and under carpets. To keep young children safe, use safety gates to block stairs and consider installing window guards.
  • Always wear recommended safety gear when playing sports. Avoid headfirst moves such as diving into shallow water, spear tackling in football, sliding headfirst in baseball, and skating headfirst into the boards in ice hockey. Use a spotter in gymnastics. Don't jump from higher than 8 to10 feet.

There is no known way to prevent multiple sclerosis, amyotrophic lateral sclerosis, or other degenerative neurologic diseases.

RESOURCES:

American Muscular Dystrophy Association
http://www.mdausa.org

The Christopher and Dana Reeve Paralysis Resource Center
http://www.paralysis.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org

The Manitoba Paraplegia Foundation, Inc.
http://www.cpamanitoba.ca

References:

Binard JE. Care and treatment of spinal cord injury patients. J Am Paraplegia Soc . 1992;15:235-249.

Dorizzi A. Guidelines for management of spinal cord injury: spinal surgery study group of the Italian Society of Neurosurgery. J Neurosurg Sci . 1997;41:133-138.

Spinal cord injury. Mayo Clinic Brain and Nervous System Center website. Available at: http://www.mayoclinic.com/invoke.cfm?objectid=FF176B51-D345-4049-99F4E7BC2B3E4A27&dsection=1 . Accessed August 8, 2005.



Last reviewed January 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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