Tetraplegia, also known as quadriplegia, is the loss of movements of the arms, trunk and legs, usually caused by injuries that reach the spinal cord at the level of the cervical spine, due to situations such as injuries in accidents, cerebral hemorrhage, serious deformities in the spine or neurological diseases.
Loss of movement may have different intensities, ranging from weakness to total loss of ability to move the limb. Depending on the level of the injury, respiratory capacity may also be impaired, and use of breathing apparatus may be indicated.
In addition, tetraplegia may be accompanied by other complications, such as:
- Changes in the sensitivity of the affected region;
- Changes in tonus of affected limb muscles, with flaccidity (flaccid tetraplegia) or spasticity (spastic tetraplegia);
- Changes in the function of the bladder and bowel;
- Neuropathic pain, which is a type of pain caused by neurological injuries. Understand better what neuropathic pain is and how to treat it;
- Sexual dysfunction;
- Osteoporosis;
- Pressure ulcers;
- Other neurological changes, such as the onset of unexplained sweating or changes in blood circulation;
Tetraplegia is different from paraplegia, because in paraplegia there is a spinal cord injury below the thoracic region, affecting the trunk and lower limbs, preserving the strength in the arms. Check out more details about Paraplegia.
To treat the changes, which can be recovered in some cases, and to readapt to daily activities, the person with tetraplegia should be accompanied not only by the neurologist, but also by a team composed of physiotherapist and occupational therapist. In addition, psychological counseling is also indicated, since the loss of physical abilities may also leave the person more vulnerable to the appearance of changes in self-esteem and depression.
What are the causes
Tetraplegia usually arises from a spinal cord injury at the level of the cervical region, impairing the communication of the nervous system with the arms and legs. The main causes include:
- Spinal injuries due to auto accidents, gunshot wounds, falls and dips. Know the main causes of spinal injuries and how to identify;
- Stroke in the medulla or specific regions of the brain;
- Tumors that affect the bone marrow;
- Spinal canal stenosis;
- Severe deformities in the spine;
- Fractures in the vertebrae, due to weakening caused by osteoporosis, osteomyelitis, bone tuberculosis or cancer;
- Herniated disc;
- Marrow infections, such as transverse myelitis or tropical spastic paraparesis;
- Neurological diseases, such as multiple sclerosis or amyotrophic lateral sclerosis, for example.
To detect tetraplegia, the neurologist must do the detailed neurological examination, which will assess muscle strength, sensitivity of the region and reflexes, being able to observe gravity, request tests and determine the best treatments.
How is the treatment done?
A person with tetraplegia can heal or partially recover the movements, however, this depends on the cause and severity of the injury.
Initial treatment is guided by cause. Spinal injuries should be treated by an experienced neurosurgeon or orthopaedist in this situation, with immobilization, traction of the region and surgery. Neurological diseases, such as stroke and ALS, are treated with the neurologist's guidance, with specific drugs for each disease.
With the quadriplegia installed, the treatment is aimed at the rehabilitation of the patient, with physical therapy, occupational therapy, physical activities and psychological counseling. The use of orthoses to correct posture or stabilize areas of the body may also be indicated.
In addition, the person with tetraplegia will need to adapt their daily activities so that they can maintain their independence as much as possible, which includes use of specific wheelchairs, support devices, food facilitators or software to control the use of the computer, for example.
A caregiver may be needed to assist in activities such as hygiene and bathing. Check out guidelines on how to take care of a bedridden person.
