- How Does It Happen?
- Signs/ Symptoms
Quadriplegia is also known as tetraplegia. It is defined as the temporary or permanent loss of sensations and movements of the upper and lower limbs. This may be the result of injury or infection to the spinal cord at the level of the neck.
The spinal cord serves as an information pathway between the environment, body, and brain. It carries the sensory inputs (sense of motion, position, temperature, pressure, and pain) from the limbs and trunk through to the brain. This transmission is done via specific nerve bundles arranged inside the spinal cord. The brain receives this nerve input and interprets the sensations accordingly and responds by activating the required muscle groups. Any form of illness or trauma that damages the nerve fibers within the spine causes disturbed function below the level of injury and paralysis.
The paralysis can be flaccid or spastic. Flaccid paralysis is when the muscles become flabby or floppy (flaccid). It results in muscle weakness. Spastic paralysis is when the muscles become tight and hard. It can cause the muscles to twitch uncontrollably. The type of paralysis, flaccid or spastic, depends on the site of the nerve damage.
Quadriplegia is the most severe form of paralysis. A quadriplegic would not be able to move the arms or legs. The torso, including breathing muscles, maybe paralyzed as well.
How does quadriplegia occur?
A fracture, any injury, or pathology to the cervical segment of the spinal cord would result in quadriplegia. The cervical spine is the part of the spine that lies in the neck region. The cervical spine consists of seven disc-like bones, called vertebrae (C1-C7 vertebrae). Vertebrae are separated from one another by intervertebral discs. The discs allow the spine to move freely and act as shock absorbers. It is possible to fracture the cervical spine without damaging the spinal cord. Paralysis occurs only when the spinal cord within the vertebrae gets injured.
What are the types of quadriplegia?
Quadriplegia is the most severe form of spinal cord injury. It is classified into two types:
- Complete spinal cord injury: This causes permanent and total loss of sensory and motor functions below the level of injury. People with this type of injury cannot feel any sensation or move the muscles controlled by the nerve fibers below the affected site.
- Incomplete spinal cord injury: In this type of injury, people retain some of the sensory or motor functions below the level of injury. They may retain varying degrees of muscle movement and sensation. They may be able to move one arm or leg more than the other or have a better function on one side of the body.
What causes quadriplegia?
Quadriplegia is mostly caused when the vertebrae protecting the spinal cord crack, become dislocated, and protrude into space where the spinal cord is located. The common causes of damage to the spine include:
- Traumatic injuries during road traffic accidents, sports accidents, etc.
- Gunshot and stab injuries
- Fall from heights
- Electric shock injuries
- Inflammation of arachnoid matter (protective membranes that cover the brain and spinal cord)
- Pathologic fractures due to rheumatic disease
- Infections and parasites
- Ischemia (decreased oxygen) due to a poor blood supply
- Tumors compressing the spinal cord
What are the signs and symptoms of quadriplegia?
Although the limbs are most commonly affected, there is also impairment in the functioning of the torso (muscles responsible for breathing). The severity of the signs and symptoms depends on the level and extent of spinal injury. The signs and symptoms include:
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How is quadriplegia diagnosed?
The diagnosis is based on the patient’s history and physical examination. The extent and site of the lesion are further confirmed with diagnostic tests, such as:
How is quadriplegia treated?
The treatment plan depends on the underlying cause and the level of injury the person has sustained. There is little possibility of reversing the damage in the spinal cord. Treatments are targeted to promote nerve cell regeneration and improve nerve functions. The basic treatment plan includes:
- Surgery to reconstruct the spine
- Immobilization during accidents
- Immune suppression drugs
- Anti-inflammatory drugs
- Pain medications
- Occupational therapy
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Science Direct. Quadriplegia. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/quadriplegia
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