Quadriplegia and Paraplegia

Injury or disease to a the nervous system can affect the ability to move a particular part of the body. This reduced motor ability is called paralysis.

• Paraplegia—paralysis of both legs or both arms
• Quadriplegia (sometimes called tetraplegia)—paralysis of both legs and both arms

Quadriplegia and paraplegia are most often caused by spinal cord injuries. But, they can also be caused by nerve diseases, such as:

• Amyotrophic lateral sclerosis (Lou Gehrig’s Disease)
• Multiple sclerosis

Most spinal cord injuries are caused by accidents (eg, car crashes, falls, sports injuries).

Whether it is paraplegia or quadriplegia, depends on:

• Location, along the spine, where the injury occurs
  • Paraplegia—damage below the neck
  • Quadraplegia—damage to the spinal cord at the base of the skull or neck

If you have any of these symptoms do not assume it is due to these conditions. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Family history of certain inheritable nerve diseases
• Jobs or sports activities that increase your chances of spinal injury—high-risk sports, such as football, rugby, wrestling, gymnastics, diving, surfing, ice hockey, downhill skiing

Paralysis due to spinal cord injuries may be total or partial. This depends on how much of the spinal cord is damaged. In addition to paralysis of the arms and/or legs, you may also suffer from:

• Sexual dysfunction ( male or female )
• Difficulty sitting upright depending on the level of the damage
• Incontinence (bladder or bowel)
• Trouble breathing

Inactivity due to paraplegia and quadriplegia can cause additional problems, like:

• Bed sores
• Chronic pain
• Pneumonia
• Spastic limbs
• Urinary tract infection
• Weakened bones

People with paraplegia and quadriplegia may also become depressed because of:

• Increased dependence on others
• Lack of emotional support
• Social isolation

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

• Myelography (rarely used)—a test that involves injecting a special dye into the spinal canal, uses x-ray or CT scans to identify the damaged areas of the spine
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the brain and spinal cord
• Lumbar puncture —a procedure to collect cerebrospinal fluid, done if neurologic disease is suspected
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the brain and spinal cord
• Nerve conduction study —test that measures the speed and degree of electrical activity in a nerve to determine if it is functioning normally, often used when the cause of the injury is not due to trauma
• Somatosensory evoked potentials (SSEPs) (rarely used)—a test to evaluate the conduction of the nerves in the spinal cord

Immediate treatment of spinal cord injuries includes bracing the bony spine to keep it from moving and further injuring the spinal cord. Steroids and other medications may be used to lessen damage to nerves and adjacent tissue.

Recovery and rehabilitation usually begins in the acute care hospital setting. Depending on the cause and extent of the condition, this involves:

• Counseling
• Intensive physical therapy
• Medications
• Surgery

During this time, patients are fitted for mobility aids, often including wheelchairs. For most people, the majority of recovery happens within the first year.

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

• Always wear safety gear when playing sports. Avoid headfirst moves, such as:
  • Diving into shallow water
  • Skating headfirst into the boards in ice hockey
  • Sliding headfirst in baseball
  • Spear tackling in football
  Use a spotter in gymnastics. Don't jump from higher than 8 to 10 feet.
• Be safe with firearms. Lock guns and ammunition in a safe place. Store them separately in locked containers.
• Drive safely. Motor vehicle accidents are the leading cause of spinal cord injuries. Wear a seat belt every time you drive. Make sure your children wear a seat belt or are in a child safety seat. Don't drive if you have been drinking or using drugs.
• Take 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 children safe, use safety gates to block stairs. Install window guards.