Index
Refers to paralysis from about the shoulders down.
The cervical lesions (neck) generally result in paralysis of four known as quadriplegia.
Quadriplegia, also known as Tetraplegia, is defined as paralysis caused by disease or injury in a human being that results in the partial or total loss of use of all his limbs and torso.
Most spinal cord injuries cause a loss of sensation and function below the level of the injury, including loss of controlled bladder and bowel function.
Paraplegia is similar but does not affect the arms.
An alteration in the motor or sensory function of the lower extremities, which means that both sensation and control are lost.
The terms tetraparesis or quadriparesis, on the other hand, mean muscle weakness that affects all four limbs.
Quadriplegia, or tetraplegia, is defined as ” four limb paralysis “, the term tetraplegia is more commonly used in Europe.
Pentaplegia is a less common term that refers to paralysis that also substantially affects head movement.
This results in the detriment of the use of all the extremities and the torso, this loss can be partial or total.
Causes of quadriplegia
Quadriplegia is caused by damage to the brain or spinal cord at a high C1 – C7 level, in particular spinal cord injuries secondary to cervical spine injury.
The injury, known as an injury, causes victims to lose partial or total function of all four limbs, that is, the arms and legs.
Quadriplegia is defined in many ways; C1-C4 generally affects arm movement more than a C5-C7 injury, however all quadriplegics have or have had some type of finger dysfunction.
Therefore, it is not uncommon to have a quadriplegic with fully functional arms, just that his fingers are not working.
Injuries above the C-4 level may require a ventilator or an electrical implant for the person to breathe.
This is because the diaphragm is controlled by the spinal nerves that exit at the upper level of the neck.
Complications of quadriplegia
Quadriplegia can cause a number of complications, including: pain, blood clots, ulcers and related injuries, spastic muscles, breathing problems, autonomic dysreflexia, loss of bladder, and bowel control.
Quadriplegia treatment is tailored to the specific needs of each patient and often depends on the nature and severity of a person’s condition.
Treatment generally addresses a patient’s loss of function and sensation in certain areas of the body, loss or impairment of organ function.
Today, spinal cord injury treatment focuses on preventing further injuries and enabling people with a spinal cord injury to return to active and productive lives within the limits of their disability.
Classification of spinal cord injuries
In general, the classification of spinal cord injuries, according to the American Spinal Injury Association, includes A-complete, B-incomplete, C-incomplete, D-incomplete, and E-normal.
Tetraplegia or quadriplegia follows the classification as such:
- C1-4, the phrenic nerves of quadriplegics can still function.
- C5, patients can move their deltoid and / or bicep muscles.
- C6, quadriplegics can move their shoulders, bend their elbows, and flex their fingers.
- C7, you can use your triceps muscles, have functional elbows, flex your fingers, and move your wrist.
The patient with a spinal cord injury will spend most of the time immobile.
Because of this, they most likely suffer from frozen joints, muscle stiffness or spasticity, deep vein thrombosis, pressure ulcers, etc.
Signs and symptoms of quadriplegia or tetraplegia
The severity of the paralysis depends on the location of the trauma or injury.
Injuries that occur in the upper region of the spinal cord, that is, the neck, result in more severe paralysis.
Injury to the neck of the spine can cause both arms and legs to become paralyzed.
Patients with this type of paralysis cannot breathe without a respirator.
Generally speaking, quadriplegics struggle with the following symptoms:
Chronic pain
This may be due to changes in sensory perception, but also due to chronic disuse.
A quadriplegic who regains some sensation may find that his arms ache due to muscle atrophy.
The patient may also experience burning neuropathic pain.
Loss of sensation below the injury site
In some cases, this loss of sensation is complete and permanent.
In other cases, the sensations are simply reduced, or you may feel some sensations intermittently but not others.
There may also be a pricking sensation such as pins and needles.
Inability to move the limbs below the injury site
Although some movements may return, the vast majority of quadriplegics continue to struggle with loss of muscle control and general weakness.
Spasticity
This involves sudden and uncontrolled movements, particularly in the areas most affected by paralysis.
Difficulties with removing the bladder
Loss of sensation and muscle control below the injury site can lead to fecal or urinary incontinence, difficulty in passing without assistance, and frequent urinary tract infections. Respiratory infections.
It can also lead to poor digestion and labored breathing.
These symptoms are particularly common in the months after an injury; these infections are the leading cause of death among spinal cord injury survivors.
Changes or difficulties with fertility and sexual function
Men may have a hard time getting erections, while women may have problems with lubrication.
Both genders often experience changes in libido, difficulties with orgasm, decreased fertility, and even complete cessation of sexual function.
Secondary infections
Due to the inability to move, secondary infections can occur, including bedsores.
Psychological concerns
In particular, there are problems of anxiety and depression .
Difficulties with body awareness
Depending on the extent to which you have lost sensation, you may have a hard time knowing where your legs or arms are without looking.
Weight gain, especially if you can’t exercise, don’t engage in physical therapy, or chronically overeat.
Many quadriplegics find that they must reduce their calorie intake to avoid weight gain.
Diagnosis
Late diagnosis of a spinal cord injury can also result in further damage to the spinal nerves. About one in three cases will end in permanent neurological deficiency.
Usually the doctor recommends a blood test, X-rays, a CT scan.
Treatment of quadriplegia or tetraplegia
Treatment of quadriplegia will be determined by the needs of the patients and the severity of the condition.
Treatment is aimed at addressing the loss of function and sensation of the patient in the paralyzed regions of the body and also the loss or impairment in any function of the organ.
If the cause is temporary, caused by a hematoma or swelling of the spinal cord, the nerves can begin to function again, with the administration of steroids to prevent and reduce inflammation of the spinal cord.
If the cause of quadriplegia is injury, there is no treatment that can reverse this condition and treatment is required to prevent further damage to the spine.
A fracture can cause the bones or discs to compress the spinal cord, in these cases surgery can help relieve this pressure, eliminate residual bone fragments, stabilize the vertebrae, realign the bones and stabilize the vertebrae .
If the patient is taken to rehabilitation regularly and with more surgeries, the patient’s condition may improve.
Partial movement can be obtained for patients with operable quadriplegia through the use of screws, metal rods, bone, muscle, and tissue from other regions of the body.
Functional electrical stimulation also helps provide partial movement to paralyzed muscles.
Patients with injuries to the upper vertebrae or nerve segments, i.e. C1, C2, C3, need a ventilator to help them breathe.
Alternatively, a phrenic nerve stimulator can be surgically placed to help patients breathe, which transmits electrical impulses to stimulate the diaphragm.
Ongoing care involves treating pressure ulcers suffered by tetraplegic patients because they are constantly in one place and these ulcers require proper wound care with debridement of necrotic tissue.
Nutrition is very important in quadriplegic patients.
Quadriplegic or tetraplegic patients need a constant caregiver to help them take care of their personal hygiene, cleanliness and also to take them to various doctors such as neurologists, physical therapists, occupational therapists, respiratory therapists, speech pathologists and psychologists.
Some people may need braces according to the injuries, to avoid further damage to the vertebrae and their stabilization.
Physical therapy for the patient is extremely important to keep his muscles strong and active.
Learning to take care of themselves is the largest part of the recovery process for patients.
Counseling for the patient is important, as losing control and function of the body is an extremely overwhelming and devastating experience for the patient.
Both the patient and the family need counseling to treat the patient’s condition together.
Cultivating a positive attitude is important to avoid depression .
