Quadriplegia
Quadriplegia, also called tetraplegia, is a condition which results in loss of function or paralysis of the muscles in arms and legs.
Quadriplegia is caused by spinal cord injury, stroke, Bell's palsy, nerve disease such as amyotrophic lateral sclerosis, and autoimmune disorder such as Guillain-Barré syndrome.
One of a type of quadriplegia is spastic quadriplegia which is a severe form of cerebral palsy. Spastic refers to muscle stiffness. Cerebral palsy is a neurological disorder that occurs in early childhood which affects body movements, balance, posture, and muscle coordination. It is a result of damage to one or more brain parts that controls muscle movements. Cerebral palsy is caused by fetal brain injuries, infections at birth or during pregnancy, severe jaundice during birth, infections of the brain such as bacterial meningitis or viral encephalitis, or head injury following an accident, fall, or child abuse. Birth injuries can also lead to cerebral palsy in some cases.
Children affected with quadriplegia have difficulty in walking, swallowing, and speaking. Muscles may become very stiff or unusually relaxed. Body movements may be jerky, abrupt, or slow and uncontrolled. The child may not react to sound or may have a delayed speech and some may also have moderate to severe mental retardation.
Your doctor will discuss with you and your family members and gather information if any problem has occurred during pregnancy and labor and may order some of tests such as:
- Ultrasound of the brain - Detect any abnormality such as bleeding or brain damage
- CT scan of the brain - Reveals any abnormalities.
- MRI of the brain - Captures the internal structure of the brain more clearly than other methods. Imaging of the spinal cord with MRI is suggested in children with spastic leg muscles and lack of bladder and bowel control.
Treatment
Treatment options include non-surgical and surgical treatment. Non-surgical treatment includes:
- Physical therapy involves stretching exercises and other activities that develop flexibility and strengthen the muscles.
- Occupational therapy teaches physical skills to function independently in life such as eating, dressing, and teeth brushing.
- Speech/language therapy enables the child to improve speech and overcome problems of communication
- Medicines are recommended to relax the muscle spasms.
- Special equipments such as walkers, positioning devices, wheelchairs help to improve function in children with cerebral palsy. Braces and other orthotic devices may be required to neutralize the muscle imbalance and improve posture and walking.
Surgery is recommended when the conservative treatments has not reduced spasticity and pain. Surgical treatment includes:
- Dorsal rhizotomy: It is a surgical procedure performed to reduce spasticity and improve the muscle movements. In this procedure, a few nerves are cut at the roots where they divide from the spinal cord.
- Intrathecal baclofen therapy: In this procedure, Baclofen-a muscle relaxant is injected into the spine to reduce muscle spasticity. A tiny pump is placed in the abdominal wall to pump the drug to the spastic muscles of the limbs.
- Tendon transfer surgery: It is performed to restore the function of the hand after spinal cord injury. In this procedure, the origin of the functioning muscle is detached and reinserted into a different bone or different tendon to improve function.
Click on the topics below to find out more from the Orthopedic connection website of American Academy of Orthopaedic Surgeons.
