Quadriplegia and Paraplegia

Causes

Paraplegia happens when there is damage below the neck. Quadriplegia happens when the damage is at the base of the neck or skull.

The most common cause is trauma, such as from a sports injury, car accident, or fall. Other causes are:

• Multiple sclerosis
• Amyotrophic lateral sclerosis (ALS)

Quadriplegia

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Risk Factors

Things that may raise the risk of these problems are:

• Playing certain sports, such as football, rugby, wrestling, gymnastics, diving, surfing, ice hockey, and downhill skiing
• A family history of certain inherited nerve diseases
• History of cancer—can cause pressure on the spinal cord

Symptoms

Paralysis may be total or partial. It depends on how much of the spinal cord is damaged. Other problems may be:

• Loss of bladder or bowel control—incontinence
• Loss of sexual function
• Trouble breathing
• Problems sitting upright

Inactivity can lead to other problems, such as:

• Pressure sores
• Abnormal muscle tightness
• Pneumonia
• Urinary tract infection
• Weakened bones
• Chronic pain

People may also become depressed because of:

• Lack of social and emotional support
• Being more dependent on others

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. Many health specialists will be involved in the diagnosis.

Blood tests will be done. The fluid around the brain and spine may also be tested. This can be done with a lumbar puncture.

Images may need to be taken of the spine. This can be done with:

• CT scan
• MRI scan
• Myelography—this is rarely used

Nerve function may be tested. This can be done with:

• Nerve conduction study
• Somatosensory evoked potentials—not used as often

Treatment

Emergency care will be needed. It can prevent further damage. Choices are:

• Steroids and other medicines to lessen damage to nerves and nearby tissue
• Surgery to stabilize the spine or ease pressure on it

Therapy

Therapy will be needed to improve function and quality of life. Choices are:

• Physical therapy—to improve strength and learn how to use assistive devices
• Occupational therapy—to help with daily tasks and self care
• Speech therapy—to help with swallowing and speech
• Psychological therapy—to provide support

Prevention

Paraplegia is often due to accidents that cannot be prevented.