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Quadriplegia is form of paralysis in which all four limbs are affected, although not necessarily total paralysis or loss of function. It is caused by damage to the brain or the spinal cord.

Alternative Names: Quadriplegia, Tetraplegia

Complications of Quadriplegia

  • Skin Breakdown
  • pneumonia
  • Osteoporosis and Fractures
  • Heterotopic Ossification
  • Spasticity
  • Urinary Tract Infections
  • Autonomic Dysreflexia
  • Deep Vein Thrombosis
  • Pulmonary Embolism
  • Orthostatic Hypotension
  • Cardiovascular Disease
  • Syringomyelia
  • Neuropathic / Spinal Cord Pain
  • Medication Problems
  • Hyperthermia

Causes of Quadraplegia
There are two categories of causes :

A) Traumatic causes: Factors mentioned below are indicative of trauma -

  • Traffic accidents
  • Domestic accidents
  • Work-related accidents
  • Sports related injuries
  • Self-harm
  • Assault 
  • Complications following surgery e.g., corrective surgery for spinal deformity e.g. scoliosis.

B) Non-traumatic causes: Factors mentioned below are indicative of non traumatic -

  • Bacterial infection of the spinal nerve cells
  • Viral infection of the spinal nerve cells
  • Cysts or tumours pressing on the spinal cord
  • Spinal cord damage caused by interruption of the blood supply
  • Congenital (present from birth) medical conditions which affect the structure of the spinal column.

Signs & Symptoms of Quadraplegia

A) Loss or impairment of  -

  • Bowel and bladder
  • Sexual function
  • Digestion
  • Breathing
  • Other nervous functions include numbness, reduced sensation or burning neuropathic pain.

B)  Due to less functioning and immobility the patient may develop these symptoms -

  • Pressure sores
  • Osteoporosis and fractures
  • Frozen joints
  • Spasticity
  • Respiratory complications and infections
  • Autonomic dysreflexia
  • Deep vein thrombosis
  • Cardiovascular disease

Diagnosis of Quadraplegia

  • Neurologic Examination:  Testing the  functioning of nerves delivering sensory information to the brain and caring motor commands (Peripheral nervous system) and impulses back to the brain for processing and coordinating (Central nervous system).
  • Physical examination:  It includes inspection of the body, palpation (feeling the body with hands), auscultation (listening to sounds) and percussion (producing sounds).
  • Bone X-ray:  Verifying any changes in the structure and compsoition
  • Spine MRI : Pictures of spine area, including the spine bones, the spinal cord, and the spaces between the vertebrae through which the nerves travel.
  • Lumbosacral spine CT:  To view the shape of the lower spine and surrounding tissues.

Treatments of Quadraplegia

  • Physical Therapy: To restore function, improve mobility, relieve pain , and prevent or limit permanent physical disabilities
  • Occupational Therapy:  A holistic, patient-specific, occupation-based therapy to improve or restore life skill development.
  • Mechanical Ventilation :  Use of machine to inflate and deflate the lungs for patients who suffer from respiratory complications.
  • Skin treatment: Cosmetic treatments including laser, botox injections and surgeries may be required if a patient develops skin related problems.
  • Spinal Traction : Application of force through body weight, other weights, and or pulleys to draw apart the vertebrae of the spine.
  • Electric Stimulation Therapy : A technique called TENS which stands for Transcutaneous Electrical Nerve Stimulation is used. It is a surgery and drug free peocedure in which electrical signals are send to underlying nerves to relieve a wide range of chronic and acute pain .
  • Decompression Laminectomy : Laminectomy is a surgical procedure that involves opening the spinal column to treat nerve compression in the spine.

Prevention of Quadraplegia
Prevention mainly includes:

  • Driving safely - Wear a seat belt every time you drive and make everyone else who is with you to waer it. Don't drive while intoxicated.
  • Storing firearms- Lock up guns and ammunition in a safe place to prevent accidental shootings.
  • Avoiding falls - Use a stool or stepladder to reach high places. Add handrails along stairways. Place nonslip mats in your bathroom, shower, and under carpets.
  • Wearing sports safety gear - Wear appropriate sports gear whenever playing. Avoid sports moves which involve head like diving into shallow water, spear tackling in football, sliding headfirst in baseball, and skating headfirst into the boards in ice hockey.
  • Exercise - Any sort of bone strengthening exercise routine which will lead to less damage during any mishap.

When to seek Medical Advice
Whenever the symptoms are pronounced it is advisable to visit a doctor.

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