Quadriplegic

WHAT IS IT?

Quadriplegia is a loss of the ability to move and/or feel both arms, both legs, and the parts of the body below the area of injury to the spinal cord, which is what causes the condition to occur. Quadriplegia is typically caused by an injury to the spinal cord (which sends messages to body parts important for movement and sensation).

UNDER WHAT CONDITIONS IS QUADRIPLEGIA MOST LIKELY TO OCCUR?

Quadriplegia is most likely to occur when a spinal cord injury is in the area of the 5th to 7th cervical vertebrae (bones in the neck that make up part of the structure surrounding the spinal cord). The 5th to 7th cervical vertebrae are located in the neck area. The reason why spinal cord injuries in this area are likely to cause quadriplegia is because the spinal cord cannot send messages below the area where it is seriously damaged. Since the arms and legs are both below the neck area, serious injury to the spinal cord in this area often leads to an inability to feel the arms, legs, and any other body parts below the level of the injury.

HOW MANY PEOPLE HAVE QUADRIPLEGIA?

Approximately 150,000 people in America have quadriplegia, and most of them are between the ages of 20 and 40.

WHAT ARE SOME CAUSES OF SPINAL CORD INJURIES THAT LEAD TO QUADRIPLEGIA?

Causes of spinal cord injuries that result in quadriplegia include a motor vehicle or motorcycle accident, gunshot wounds, and falls.

HOW IS QUADRIPLEGIA TREATED?

Treatment of quadriplegia begins at the scene of the accident. To prevent further damage from occurring at the scene of the spinal cord injury, health care professionals strap the injured person to a special type of board and place a brace around the person's neck to prevent the spine or neck from moving. Once a person with a spinal cord injury comes to the hospital, the neck and head may be prevented from moving by being placed in a special metal device known as a halo. This device is called a halo because it forms a circle around the head, much like the halo of an angel.

Medications known as diuretics and steroids are administered to decrease any buildup of fluid in the spine that is caused by leakage from dead cells. After additional therapy, surgery is often performed to remove any pieces of bones and to fuse (combine) together any unstable sections of the bones that surround the spine.

Health care providers also need to make sure that many types of complications are avoided or treated quickly in patients with quadriplegia. For example, to treat hypothermia (abnormally decreased body temperature), the person is placed in blankets. Hot water bottles or electric heating devices are not used because the skin can get burned due to sensory loss. To provide support to the abdomen (belly) area due to weak muscles, a bandage known as an abdomen binder is wrapped around it. To prevent blood clots, the patient is given special stocking to wear on the legs. Pressure sores, which develop from staying in the same position for an extended period of time, also need to be prevented.

The heart rate is monitored regularly and slow heart rate is treated with special medications known as antimuscarinic drugs. Hardened feces (affectionally known to many as #2) are important to monitor because it can cause high blood pressure. To understand how stimulation of the body by hardened feces or other causes can lead to high blood pressure in people with quadriplegia, please see the entry for autonomic dysreflexia. Blockage of tubes inserted into the body to drain or enter fluids also needs to be monitored. The proper functioining of the digestive system needs to be monitored as well.

HOW IS QUADRIPLEGIA DIAGNOSED?

Quadriplegia is diagnosed by interviewing the person with the suspected condition and conducting a complete physical and neurological examination. To assess for other injuries, X-rays of the head, chest, and the abdomen (belly) are taken. X-rays and myelography (a type of picture of the spinal cord and spinal nerves, using radiation) of the spine are done to examine for any blockages in the spinal cord or fractures in the bones that surround the spinal cord.

WHAT ARE COMMON CHARACTERISTICS ASSOCIATED WITH QUADRIPLEGIA?

When quadriplegia occurs, it is characterized by a decrease in the normal level of tension that exists in muscles of the arms and legs. There is also a loss of power and sensation below the area of the spinal cord injury. Many people with quadriplegia die of breathing failure because voluntary control over the muscles and organs that are necessary to breathe is dramatically impaired. Thus, it is crucial for health care providers to make sure that someone with quadriplegia can breathe properly. To help people with quadriplegia breathe properly, they may need a machine known as a respirator that artificially breathes for them.

Some people with quadriplegia develop heart complications when the spinal cord is injured above the level of the 5th cervical vertebrae (located in the neck). The reason for this is because the spinal cord injury causes connections to become interrupted between the spinal cord and the sympathetic nervous system (a system that generally excites the body by doing things such as increasing both the heart rate and blood pressure).

A life threatening condition known as autonomic dysreflexia can be caused by interruptions between the connections of the spine to both the sympathetic and parasympathetic nervous system (a system that generally calms the body down by doing things such as decreasing both the heart rate and blood pressure). In autonomic dysreflexia, the sympathetic and parasympathetic nervous systems (which generally work in opposition to each other) are activated at the same time, and this causes all sorts of serious problems. The sympathetic and parasympathetic nervous systems make up the autonomic nervous system. Interrupted connections between the spinal cord and the autonomic nervous system can lead to other difficulties such as low body temperature and loss of bowel and bladder control.

WHAT ELSE IS QUADRIPLEGIA KNOWN AS?

Quadriplegia is also known as hemiplegia.

WHAT IS THE ORIGIN OF THE WORD, "QUADRIPLEGIA"?

Quadriplegia comes from the Latin word "quattuor," meaning "four," and the word "plege," meaning "stroke." Put the two words together and you have "four stroke," referring to the four limbs (arms and legs) of the body. A stroke is a burst artery (a type of blood vessel that carries blood away from the heart) or a blockage of an artery in the brain. Because strokes sometimes lead to loss of movement and/or sensation in parts of the body, the word "plegia" is used to refer to such conditions. Strokes and other types of brain damage also lead to hemiplegia (loss of sensation and/or movement on the right or left side of the body).