Quadriplegia | Types of Paralysis | Brain and Spinal Cord …

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What Is Quadriplegia?

Paralysis can be either partial, periodic, complete, or incomplete. Paralysis of both the arms and legs has been traditionally been called quadriplegia. Quad comes from the Latin for four and plegia comes from the Greek for inability to move. Currently the term tetraplegia is becoming more popular, but it means the same thing. Tetra is from the Greek for inability to move.

The primary cause of quadriplegia is a spinal cord injury, but other conditions such as cerebral palsy and strokes can cause a similar appearing paralysis. The amount of impairment resulting from a spinal cord injury depends on the part of the spinal cord injured and the amount of damage done. Injury to the spinal cord can be devastating because the spinal cord and the brain are the main parts of the central nervous system, which sends messages throughout your body.

When the spinal cord is injured the brain cannot properly communicate with it and so sensation and movement are impaired. The spinal cord is not the spine itself; it is the nerve system encased in the vertebrae and discs which make up the spine.

Quadriplegia occurs when the neck area of the spinal cord is injured. The severity of the injury and the place it occurred at determine the amount of function a person will maintain. A major spinal cord injury may interfere with breathing as well as with moving the limbs. A patient with complete quadriplegia has no ability to move any part of the body below the neck; some people do not even have ability to move the neck.

Sometimes people with quadriplegia can move their arms, but have no control over their hand movements. They cannot grasp things or make other motions which would allow them a little independence. New treatment options have been able to help some of these patients regain hand function.

Quadriplegia causes many complications which will need careful management:

Immediate treatment of quadriplegia consists of treating the spinal cord injury or other condition causing the problem. In the case of a spinal cord injury, you will immobilized with special equipment to prevent further injury, while medical personnel work to stabilize your heart rate, blood pressure, and over all condition. You may be intubated to assist your breathing. This means that flexible tube carrying oxygen will be inserted down your throat. Imaging tests will be used to determine the extent of your injury.

Surgery may be needed to relieve pressure on the spine from bone fragments or foreign objects. Surgery may also be used to stabilize the spine, but no form of surgery can repair the damaged nerves of the spinal cord. Unfortunately, the nerve damage caused by the initial spinal cord injury has a tendency to spread. The reasons for this tendency are not completely understood by researchers, but it is related to spreading inflammation as blood circulation decreases and blood pressure drops.

The inflammation causes nerve cells not directly in the injured area to die. A powerful corticosteroid, methylprednisolone (Medrol) can sometimes help prevent the spread of this damage if it is given within eight hours of the original injury; however, methylprednisolone can cause serious side effects and not all doctors are convinced that it is beneficial.

Rehabilitation for quadriplegia once consisted primarily of training to learn how to deal with your new limitations. Passive physical therapy was given to help prevent the muscles from atrophying. Today, many new options are offering quadriplegia patients new hope. These new options combine older methods with new technology with encouraging results.

While passive physical therapy once consisted solely of the therapists manipulating the patients arms and legs in an effort to increase circulation and retain muscle tone, today therapists can use electrodes to stimulate the patients muscles and give them an optimal workout. This technology is called functional neuromuscular stimulation (FNS). FNS stimulates the intact peripheral nerves so that the paralyzed muscles will contract.

The contractions are stimulated using either electrodes that have been placed on the skin or that have been implanted. With FNS, the patient may ride a stationary bicycle to improve muscle and cardiac function and prevent the muscles from atrophying. An implantable FNS system has been used to help people with some types of spinal injury regain use of their hands.

This is an option for people with quadriplegia, who have some voluntary use of their arms. The shoulders position controls the stimulation to the hands nerves, allowing the individual to pick up objects at will. Tendon transfer is another option which allows some people with quadriplegia more use of the arms and hands. This complicated surgery transfers a nonessential muscle with nerve function to the shoulder or arm to help restore function. FNS may be used in conjunction with tendon transfer.

Other forms of treatments for quadriplegia are still in the experimental stage. Many clinical trials of new treatment options are run every year. If you or a loved one suffers from quadriplegia, you may want to consider one of these trials. Ask your doctor to help you find a suitable trial.

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Quadriplegia | Types of Paralysis | Brain and Spinal Cord ...

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