Quadriplegia

Quadriplegia

Overview

Quadriplegia is a pattern of paralysis — which is when you can’t deliberately control or move your muscles — that can affect a person from the neck down. Depending on how and why it happens, it can affect your ability to move parts of your body, as well as some of your body’s automatic processes that keep you alive.

Quadriplegia (also known as tetraplegia; see below for an explanation of these terms) is usually a symptom of other problems, but there are some instances where it’s a standalone condition. Overall, quadriplegia is the most common symptom of traumatic spinal cord injury, happening in about 60% of cases.

There are also two main ways, complete and incomplete, that quadriplegia can happen.

Incomplete quadriplegia. This means that the quadriplegia blocks some — but not all — signals from getting through. That means a person might still have some ability to move, feel sensations or control automatic body processes (such as bowel and bladder function). This happens with about one-third of traumatic spinal cord injuries.

Complete quadriplegia. This means whatever causes the quadriplegia blocks all signals from getting through. That means a person loses muscle control, the ability to feel sensations and their brain can’t manage any automatic processes that rely on brain signaling to work. This happens with about 20% of spinal cord injuries.

There are also two main ways that paralyzed muscles act in quadriplegia:

Flaccid quadriplegia: This means that muscles don’t work at all and remain flaccid or limp.

 Quadriplegiaza This type of quadriplegia results in muscles that don’t work by themselves and contract uncontrollably.

Quadriplegia vs. tetraplegia

The words “quadriplegia” and “tetraplegia” mean the same thing: paralysis below the neck that affects all of a person’s limbs. The reason that there are two terms with the same meaning is because of differences in ancient languages.

There are three ancient root words from two different languages involved in these terms:

Quadri-: This root word is Latin and means “four.”

Tetra-: This root word is Greek and also means “four.”

-plegia: This root word means “paralysis” in Greek.

So, while both words mean the same thing, “quadriplegia” mixes Latin and Greek. Experts usually consider “tetraplegia” the correct term because it doesn’t mix parts of two different languages.

How does the location of a problem affect quadriplegia?

Your spine has several sections. The cervical spine (often shortened to C-spine) is the section in your neck. There are seven vertebrae (the word for one of these is “vertebra”), interlocking bone segments, which make up your C-spine. Your C-spine also includes eight spinal nerves, which run in-between vertebrae and lead to different areas of your body.

The effects of a problem with a spinal cord can vary widely depending on where exactly it happens. There are also varying definitions of “paralysis.” Some experts define it as a total loss of muscle control, while others include muscle weakness under the definition. Because of that, some definitions of quadriplegia include limited movement ability in your arms or hands.

Healthcare providers use a letter-number combination to talk about sections of the spine and related spinal nerves. For example, the fifth cervical spinal nerve is known as C5. Quadriplegia can happen when there’s a complete or incomplete spinal cord injury anywhere between C1 and C8. The higher the injury, the more dangerous the effects.

The effects, depending on location, are as follows:

C1 to C2: Complete paralysis of all four limbs and the muscles that control your breathing. These injuries are almost always deadly without immediate care, especially breathing support (ventilation). Injuries at this level can also cut off your brain’s connection to other parts of your autonomic nervous system, which manages automatic functions like sweating, blood pressure control, digestion, and the muscles in your bladder and bowels you deliberately relax so you can pee or poop.

C3 to C4: Same as above, but damage that’s closer to C4 may not block your brain’s control of breathing muscles. Some breathing problems are still possible, and coughing is severely affected, which increases the risk of developing pneumonia as a complication.

C4 to C8: Varying levels of paralysis in your arms and hands. The further down your spinal cord, the less widespread the effects of the paralysis.

Possible Causes

What are the most common causes of quadriplegia?

There are many possible causes of quadriplegia. The most common reason people have this symptom is trauma (injury) to their spinal cord. The most common causes of trauma include:

Motor vehicle crashes (especially without the use of seat belts or when the crash causes a person’s ejection from a vehicle).

Falls (especially those that involve older adults who have bone density-related issues like osteoporosis or osteopenia).

Violence-related injuries (gunshot wounds, stab wounds, blunt impact, etc.).

Sports-related injuries.

Other problems that can cause quadriplegia include, but aren’t limited to, the following:

Spine tumors, including cancers. This can involve cancer that develops on or around your spinal cord, or that starts elsewhere in your body and spreads to your spine.

Cysts or fluid-filled cavities within your spinal cord (syringomyelia).

Infections that attack or compress your spinal cord.

Lack of blood flow (ischemia) due to a blocked blood vessel or blood vessel rupture.

Congenital conditions (that you have when you’re born) where you have a problem with your spine or spinal cord structure, such as myelomeningocele or spina bifida.

Injuries that happen during birth or very early childhood, causing conditions like cerebral palsy.

Autoimmune or inflammatory conditions like Guillain-Barré syndrome, multiple sclerosis or transverse myelitis

Treatment

How is quadriplegia treated?

The treatments for quadriplegia can vary widely depending on the cause and where in your spine the problem happens. The potential to recover from quadriplegia can also vary.

With trauma, the first priority is to limit the damage as much as possible and prevent more from happening. That usually involves immobilizing a person using specialized backboards, collars or braces to keep their spinal cord stable and prevent anything from pressing into or damaging it.

Other ways to prevent damage to the spinal cord from injuries and trauma include:

Early surgery to relieve pressure around the spinal cord.

Early surgery to stabilize or fuse vertebrae together to keep them from damaging the spinal cord.

Because of these factors, a healthcare provider is the best person to explain the situation. They can offer you guidance and relevant information for your specific situation, including the possible treatments and the side effects or complications that can happen with those treatments.

What can I do at home to treat quadriplegia?

IMPORTANT: If you’re with someone who has an injury that could affect their spine, it’s very important that you call 911 (or your local emergency services number immediately) and avoid doing anything that could make the injury worse.

Quadriplegia is a symptom of a problem that happens with many conditions and problems that affect your brain or spinal cord. Many of these problems and conditions are dangerous or deadly. Because of that, you shouldn’t try to self-diagnose or self-treat quadriplegia.

Even small movements or shifts in vertebrae and tissue around your spinal cord can lead to permanent damage. Only trained medical professionals or first responders should attempt to move someone with a possible spinal cord injury. The ONLY exception to this guidance is if the injured person is at risk for immediate injury or death if you don’t move them (such as in the event of a motor vehicle crash where the person is in a vehicle that may catch fire).

How can quadriplegia be prevented?

The most common cause of quadriplegia (trauma) is often preventable. The best things you can do to prevent spinal injuries and trauma are:

Wear safety equipment. Safety restraints (like seat belts) should be used whenever recommended. Seat belts and other restraints can help avoid injuries that could lead to quadriplegia. People playing sports should always use recommended safety gear, too. Helmets and padding are essential, as are playing conscientiously and safely. That means avoiding tackling/hitting from behind in contact sports like football, hockey, etc.

Take precautions to avoid falls. Use safety equipment, especially safety harnesses, when working on a roof or another elevated environment. You should also take steps to avoid falls in the home, especially with stairs or in bathrooms. This can include installing handrails, using non-slip footwear and floor surfaces, keeping stairs clear of tripping hazards.

Be careful when using firearms. Gunshot wounds are one of the most common causes of spinal cord injuries that lead to paraplegia. You should ALWAYS treat firearms with extreme caution, no matter the circumstance. Act as if they’re loaded even if you’re absolutely certain they aren’t. You should also store firearms unloaded, secured with a trigger lock and out of reach of children. It's also wise to store ammunition separately under lock and key.

Avoid misusing prescription medications, recreational drugs and alcohol. These can affect your immune system’s ability to fight infection. They can also increase your risk of injury from falls, car crashes, etc.

Type of Doctor Department : A  neurologist