Quadriplegia

Quadriplegia is the total or partial loss of sensation and motor control in all limbs. This type of paralysis may be caused by an injury or illness that affects the brain or spinal cord at the level of the cervical vertebrae (C1 to C7), which are found in the neck. Quadriplegia can be accompanied by many other symptoms, such as UTI and constipation. Immediate treatments are necessary, and rehabilitation must be applied to help patients with their body function to make them live easier.

Symptoms of Quadriplegia

Symptoms

The neck (cervical) portion of the spine is composed of eight vertebrae (bones of the spine), which protect the spinal cord in this area. These are called the C1 to C8 vertebrae. Symptoms of quadriplegia depend on the level of damage or injury in the spinal cord. Sensory and motor functions of the limbs and torso may be affected in varying degrees.

• In general, the higher the level of damage in the cervical spinal cord, the worse are the symptoms. Thus, damage at the level of C8 may result in loss of function from your chest down, but you may still retain use of your arms and hands. However, damage at the level of C1 will result in loss of function from your neck down. This means that one will require permanent ventilatory assistance for breathing using a ventilator machine.
• Upper cervical injuries may also lead to loss of bladder and bowel function as well as digestive and sexual functions.
• Sensations may range from complete numbness, reduced sensitivity to burning pain (neuropathy).
• Complete spinal cord injuries are associated with worse symptoms compared to those of partial cord injuries. Completely severed spinal cords result in total loss of sensation and motor function below the level involved while partially damaged spinal cords lead to partial loss of functions in varying degrees.

Complications

• The nerves of the spinal cord control bladder and bowel functions, so quadriplegic people may experience frequent urinary tract infections and constipation.
• Quadriplegia often results in being bed ridden, which increases one’s risk for developing pressure sores. Lack of mobility and inadequate care of pressure sores can lead to serious infections.
• Immobility leads to slowing down of circulation, which could lead to formation of blood clots. A deep vein thrombosis or a blood clot in the leg and pulmonary embolism or a blood clot in the lung may be fatal if not treated early.
• Quadriplegia can result in loss of breathing function, which may require permanent assistance from a ventilating machine. Pneumonia and other lung infections may occur.
• High-level cervical cord damage may lead to abnormal reflexes that disrupt body functions, such as a drop in heart rate or a spike in blood pressure, which could lead to stroke. These reflexes may be triggered by simple irritating stimuli such as a full bladder.
• Some quadriplegics have spastic muscles, which cause jerking movements of the extremities.
• Quadriplegics may be numb to external stimuli but they may feel intense burning pain within the arms, back, legs, or other parts of the body.
• Because of numbness, quadriplegics are not aware that part of their body may be injured due to burns or other external causes.

Causes of Quadriplegia

Damage to the spinal cord at the level of the cervical spine (C1-C8) is the main cause of quadriplegia. Damage may be due to injury in the neck area, which may lead to total or partial loss of function in both arms and legs. Injuries may be related to a fall, a car crash, or a sports-related accident. Other spinal cord injuries may be caused by a bony spur or a ruptured disc in the spine, which do not affect the vertebrae. Diseases such as poliomyelitis and congenital disorders like muscle dystrophy may also affect the spinal cord.

Treatments for Quadriplegia

Immediate treatment of spinal cord injury requires hospitalization. After the patient’s condition is stabilized, he/she will undergo rehabilitation, a type of treatment program that helps patients optimize body function and take care of themselves. These include:

1. Braces

A Philadelphia cervical collar or a halo brace may be prescribed to support an injured neck. Other types of braces such as a body cast or body jacket may be used for injuries in the chest or back.

2. Medications

Patients need to learn what medicines to take and how to take them. These may include:

• Steroids, to reduce swelling of the spinal cord and to improve blood flow.
• Osmotic diuretics, to decrease swelling of the spinal cord
• Blood pressure medications, to reduce blood pressure, which may increase after the injury

3. Special Cares

• Bowel/Bladder Programs. Under these programs, caregivers will help patients manage urination and bowel movements.
• Respiratory Care. Respiratory therapists help manage respiratory (breathing) systems to optimize function and prevent complications.
• Skin Care. Caregivers help patients care for their skin and prevent them from developing pressure sores.

4. Therapies

• Mental Health Therapy. Therapists help patients and their families to cope with the psychological aspects of the condition, including depression.
• Occupational Therapy. Therapists will teach patients how to live independently by doing activities of daily living such as getting dressed, eating, and some work-related skills as well.
• Physical Therapy. Patients need to keep muscle strong and joints limber by staying active. Therapists teach patients how to use the wheelchair and how to move around, such as from their bed to a commode or a chair.
• Recreational Therapy. Therapists train patients to develop some skills to keep them active in the community.