Quadriplegia

From ArticleWorld

Quadriplegia is a neurological condition where an individual loses function to most or all aspects of the upper and lower extremities. Depending on the cause and the degree of nerve involvement, breathing function can be impaired as well. About 5000 cases of injuries resulting in quadriplegia occur in the U.S. per year, while up to 1000 cases occur in the U.K.

Causes

The vast majority of quadriplegia occurs as a result of cervical spine trauma in incidents such as diving accidents, motor vehicle accidents, falls or penetrating trauma, such as a gunshot wound, that severs or partially severs the cervical spinal cord. In rare cases, birth trauma from hyperextension of the infant neck can lead to congenital quadriplegia. Tumors involving the cervical spine or cervical spinal stenosis (narrowing) cause progressive disability unless caught and reversed early.

Symptoms

The symptoms of quadriplegia vary with the level and extent of spinal cord involvement. Injury at or above the fourth cervical vertebra (C4) can impair an individual’s ability to breathe on their own. They must then require the use of a ventilator on an ongoing or intermittent basis. A lower level of injury, such as at the C5 or C6 level, may allow a quadriplegic to have limited movement of the arms on one or both sides. If the spinal injury is incomplete, one arm may function better than the other. Sensation may be partially intact in incomplete cervical injuries.

In the initial stages of quadriplegia, the muscles of the body at and below the neck are weak and floppy. Over time, however, spasticity (stiffness) of the muscles occurs as a result of having no input from the brain. The stiff muscles must be worked with in physical therapy so that they don’t lock the joints of the arms and legs. Generally, the muscles become atrophic (smaller) as a result of disuse. Quadriplegics also lose bowel, bladder and erectile function due to lack of innervation to those body areas.

Complications

Because quadriplegics have little or no ability to move, they can develop pressure sores from sitting or lying in one position too long. These sores are painless because the patient does not feel anything and, as a result, they can become deep and infected. Actor Christopher Reeve died as a result of an infected pressure sore. Quadriplegics are at an increased risk for urinary tract infections and pneumonia. Constant nursing attendance can reduce the risk of these complications.