Tetraplegia: incomplete, causes, symptoms

Tetraplegia, also known as quadriplegia, is a condition of paralysis affecting all four limbs of the body. It follows a lesion of the spinal cord at a high point above the fifth cervical vertebra, usually after trauma or accident. Explanations with Dr. Laura Terrier.

Definition: What does tetraplegic mean?

Tetraplegia is defined by the Paralysis of all four limbs of the body due to spinal cord injury (mark)” summarizes Dr. Laura Terrier, neurosurgeon, together. The damage affects the spinal cord and the transmission of nerve impulses no longer takes place at the level of the nerve roots lying below the lesion. It is generally accompanied by Bladder and sphincter disorders and associated with a fracture or dislocation of the cervical vertebrae. One of the most common causes is a traffic accident. Paralysis, represented by the inability to move, is accompanied by a numbness in the same areas with loss of pain sensation, touch. It causes great disability as the person becomes dependent for all gestures of daily life. The autonomy of the tetraplegic is variable and depends only on the remaining functions of his upper extremities, emphasizes the association for victim support 2AV. With complete paralysis, the patient is completely dependent on those around them for the smallest actions of everyday life.

What is complete or incomplete quadriplegia?

A distinction is made between complete and incomplete quadriplegia. “It’s about Complete quadriplegia with a total lack of feeling and motor skills below the spinal cord injuryand quadriplegia incomplete (tetraparesis) with persistent sensitivity and/or voluntary mobility below the lesion, especially in the perineal area‘ the specialist explains. Tetraplegia is usually caused by a Lesion over the first dorsal vertebrai.e. a cervical lesion.

What is flaccid quadriplegia?

“Sleeping quadriplegia is defined by a Paralysis unrelated to spasticity‘ the doctor replies.

What is spastic quadriplegia?

“Spastic tetraplegia is characterized by a Paralysis associated with spasticityThat means Stiffness and excessive, involuntary muscle contraction“.

What are the differences between paraplegia and quadriplegia?

Depending on the location of the lesion of the central nervous system, we speak of:
quadriplegia (or quadriplegia): “it is a paralysis of the four limbs due to a spinal cord injury (at the level of the cervical vertebrae)”.

► “That paraplegia affects paralysis of both lower extremities due to spinal cord injury (at the level of the thoracic and lumbar vertebrae)
► Finally hemiplegia is paralysis of half of the body (upper and lower limbs) due to a contralateral brain injury.

What are the symptoms of quadriplegia?

The symptoms are below the spinal cord injurye, confirms our interlocutor.
► Symptoms Engines : Decrease or loss of motor skills (loss of walking and standing, mobility in a wheelchair), muscle spasms or contractures especially if the paralysis is not complete.
► Symptoms sensitive : decrease or loss of skin sensitivity;
► The Pains ;
► Symptoms breathing (associated with paralysis of the respiratory muscles): They can range from simple shortness of breath to a Apnea which becomes very important in very high lesions (neck) where the diaphragm is paralyzed;
► Symptoms digestive : intestinal transit disorders, constipation, diarrhea, etc.
► Symptoms Urine- : urinary incontinence or, on the contrary, urinary retention
► Symptoms sexually : erectile and ejaculation disorders, frigidity…
The paralysis is responsible for a severe disability with a loss of autonomy for all gestures of daily life.
“Long-term complications associated with disability can occur. They are alright:

  • uro-digestive : urinary tract infections, kidney and bladder stones, intestinal obstruction
  • Cardiovascular : phlebitis and pulmonary embolism
  • Bony : fractures, deformations
  • skin : bedsores

What are the causes of quadriplegia?

Quadriplegia is caused from spinal cord injury. The spinal cord is located in the canal formed by the spine. “It is the structure from which all the nerves that control motor and sensitivity control, but also other functions such as sphincter control, the doctor continues. The spinal cord injury thus leads to an interruption in the transmission of nerve impulses at the level of the underlying nerve roots.“.”In more than half of the cases, the lesion is caused by trauma, including motor vehicle and sports accidents, particularly vertebral fractures resulting in a spinal cord injury. In other cases, the causes may be :

  • Degenerative (cervical disc herniation, cervico-osteoarthritic myelopathy)
  • contagious (Tuberculosis)
  • Flammable (Guillain-Barré Syndrome, Multiple Sclerosis)
  • vessel (Thrombosis)
  • malformations and tumors

What are the consequences of quadriplegia?

Quadriplegia is the result loss of voluntary use of all four limbs, 2 legs and 2 arms“The consequences depend on the location and extent of the injury.”If the lesion is at the level of the first cervical vertebra, there is a risk is a paralysis of the four limbs and impaired breathing, that is, the patient may be dependent on a ventilator. If the lesion is at the level of the last cervical vertebra, Paralysis can affect the lower limbs.”

“The diagnosis is tetraplegia clinicaladds dr terrier added. It can be confirmed by evidence of a spinal cord lesion on a MRI (Magnetic resonance imaging)”.

Can tetraplegia be treated?

There is no treatment to repair the spinal cord and cure quadriplegia

The treatment of the cause, i.e. the spinal cord injury, is complex and can be carried out with medication or surgery. “The prognosis depends on the level of the lesion and the speed of treatment. the surgical treatment consists decompress the spinal cord and/or fix unstable vertebrae (osteosynthesis or arthrodesis),” concludes the specialist. Currently, in the case of complete tetraplegia, there is no treatment to repair the spinal cord and cure the tetraplegia. Treating the consequences, the disability, is essential. “The person becomes dependent for all gestures of daily life“. Interdisciplinary care (Doctors, nurses, physiotherapists, occupational therapists, social workers and clinical psychologists) is then possible. “His goals are Alleviating symptoms, optimizing recovery and improving independence Patients, especially in the gestures of daily life. It rests on the re-educationprevention and treatment associated complications (uro-digestive tract, cardiovascular, bone, skin). Note that it is possible to apply to the MDPH (Department for the Disabled) of your residential district to have your disability recognized and benefit from rights and support (social workers, residential home…)“. In quadriplegia, independence is often more precarious or even impossible for many essential gestures, recalls the APF France Handicap website. Often, help from a third party is then necessary for everyday activities and basic care (urinary and intestinal disorders, prevention of wounds -decubitus- of the skin due to immobility and lack of perception of pain, etc.).

thanks to dr Laura Terrier, neurosurgeon at Rouen University Hospital.

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