Tetraplegia or quadriplegia is medical term used for paralysis of all four limbs; the two hands, two legs as well as the trunk region. It occurs due to injury to spinal cord, mainly involving the cervical region of spinal cord (C1-C7). In this condition both sensory and motor functions are lost. This means there is no sensation as well as movement. The extent of paralysis will depend on the severity of spinal cord injury or disease. It will also depend on whether the patient is undergoing any rehabilitative therapy. The term tetraplegia and quadriplegia have same meaning.Quadriplegia is often used in North American whereas tetraplegia is frequently used in Europe.
Causes of Tetraplegia or Quadriplegia:
Quadriplegia in majority of cases is caused due to injury to spinal cord. In few cases it can also occur due to other medical reasons. Spinal cord injury most commonly occurs in young men, although any individual is susceptible for spinal injury. Following are some of the important causes that can lead to quadriplegia:
- Injury to spinal cord at the level of cervical region. The nerve roots originating from spinal cord in this region are damaged. The common cause of injury is motor vehicle accidents, sports related injury, or a fall from height, gunshot injuries etc. All the mentioned injuries can lead to fracture of cervical vertebra and resultant damage to the spinal cord.
- Tumor or growth in the spinal canal can compress the spinal cord leading to quadriplegia. It lesion is mainly at the level of cervical region.
- Medical condition in the spinal cord as in case of severe compression of the vertebra as in case of cervical spondylosis can result in quadriplegia.
- Infections such as polio myelitis, tuberculosis of spine can and diseases such as transverse myelitis, multiple sclerosis can lead to paralysis of the limbs and trunk.
- Congenital deformities of spine such as spina bifida.
Symptoms of Quadriplegia
The symptom severity of quadriplegia will depend at which level the spinal cord is injured or damaged. Usually quadriplegia occurs when the spinal cord is damaged at the level of cervical spine. The more higher the lesion or trauma the more severe are the symptoms. Normally injury or lesion below the C7 level of spinal cord spares the upper arm. It only involves lower limbs. In quadriplegia the sensation as well as motor functions from the neck downwards are lost. This is striking feature of quadriplegia. Along with it respiration and other functions are also hampered. Here are some notable symptoms of quadriplegia:
- Loss of hand and leg movement
- Loss of bladder and bowel control.
- Erectile dysfunction and inability to ejaculate in men.
- Difficulty in breathing as the respiratory muscles is paralyzed.
- Digestive disturbances
- Numb feeling in limbs and other body parts below the neck.
- In some cases patient may experience burning pain due to neuropathy.
Treatment of Tetraplegia
Treatment of a patient suffering from quadriplegia will depend on many factors. It will depend on the severity and extent of damage to the spinal cord. Treatment is also focused on the affected paralyzed area of the body. The loss of certain functions such as bowel function and bladder functions are addressed accordingly.
- If there is swelling of the spinal cord, where the nerves are least damaged there is bright hope of recovery with administration of steroids. Steroids will reduce swelling of the spinal cord.
- In case of an injury, patient needs emergency treatment. Patient is immediately immobilized to prevent further injury to the spinal cord and shifted to emergency room in the hospital. Once the vital sign such as pulse, blood pressure is stabilized, patient will need surgery to repair the fractured vertebra and to remove fragment of bones that are compressing the spinal cord. Although the spine is stabilized and repaired, there is no possibility of repairing the damaged nerves.
- Care is taken to prevent bed sores. If the sores develop, it needs proper care of the wound and regular debridement of the dead tissue.
- In the hospital patient may need ventilator for breathing, especially when the injury is in cervical spine 1, 2, and 3.
- Patient requires proper nutrition consisting of all essential nutrients.
- A catheter is inserted through the urethra into the bladder from easy passage of urine.
- Patient may need cervical braces or any other brace as required to keep the vertebra stable.
- Physiotherapy is important for all quadriplegics as it will help to strengthen the muscle power and keep the muscles active.