QUADRIPLEGIA

Description:

Cervical (neck) injuries resulting in four limb paralysis (Paralysis of both the arms and legs)

Symptoms:

  • Motor or sensory impairment to the arms and legs
  • The loss of function in the torso
  • Sensory loss manifesting as numbness
  • Reduced sensation or sore burning neuropathic pain
  • Finger dysfunction
  • Bowel and bladder incontinence
  • Sexual dysfunction
  • Impaired digestion
  • Difficulty in breathing
  • Patient experiences numbness and decreased sensation
  • Patient may also experience burning neuropathic pain
  • Loss of bowel or bladder control
  • Exaggerated reflex activities or spasms
  • Changes in sexual function, sexual sensitivity and fertility
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in spinal cord
  • Coughing or clearing secretions from your lungs

Causes:

  • Damage to the spinal cord
  • Cerebral palsy and strokes
  • Tumor in the spinal canal may also cause quadriplegia
  • Other medical conditions in spinal cord may also result in quadriplegia
  • Certain diseases like polio, transverse myelitis and spina bifida

Risk Factors:

  • Gender: Spinal cord injuries affect a disproportionate amount of men
  • Age: persons aged between 16-30 years.
  • Older people (aged above 60)
  • Falls in older adults- cause injuries
  • Engaging in risky behavior (Diving, Sports, motor vehicle crashes)
  • Having a bone or joint disorder

Diagnostic Tests:

  • Doing a complete health history analysis
  • Physical examination
  • Neurological exam (reveal brain damage)
  • X-rays
  • CT scan
  • MRI
  • Electromyography tests ( to check electrical activity of the muscles)
  • A lumbar puncture (spinal tap) may be performed to rule out infection

Differential Diagnosis:

  • Aortic Dissection
  • Epidural and Subdural Infections
  • Hanging Injuries and Strangulation
  • Neck Trauma
  • Spinal Cord Infections
  • Syphilis
  • Vertebral Fracture
  • Brain abscess
  • Cervical spondylosis
  • Degenerative disease of the spinal column
  • Guillain-Barré (paraplegia or quadriplegia)
  • Malignant tumor (paralysis, paraplegia or quadriplegia)
  • Motor system disease (paraplegia or quadriplegia)
  • Multiple cerebral accidents (quadriplegia)
  • Paralytic poliomyelitis (paraplegia or quadriplegia)
  • Syringomyelia (paraplegia or quadriplegia)
  • Vitamin B12 deficiency (paraplegia or quadriplegia)

Treatments:

  • Trauma Care
  • Immobilization of the spine
  • Rehabilitation
  • Surgery
  • Physical therapy
  • Administration of thrombolytic agents (for arterial thrombosis)

Medications:

  • Modern wheelchairs
  • Steroids are given to prevent and reduce any swelling of the spinal cord
  • Intravenous (IV) methylprednisolone (acute spinal cord injury)
  • Computer adaptations
  • Electronic aids to daily living(EADL)
  • Electrical stimulation devices
  • Robotic gait training

Lifestyle Management:

  • Wearing body braces according to their injuries
  • Treating the pressure sores
  • Constant caregivers (to take care of personal hygiene, cleanliness of pateints)
  • Proper Nutrition is very important
  • Counseling
  • Looking ahead (remaining hopeful about the future)