Quadriplegia

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Overview
Quadriplegia, also known as tetraplegia, is a symptom in which a human experiences paralysis affecting all four limbs, although not necessarily total paralysis or loss of function.

Causes
It is caused by damage to the brain or to the spinal cord at a high level - in particular spinal cord injuries secondary to an injury to the cervical spine. The injury causes victims to lose partial or total mobility of all four limbs, meaning the arms and the legs. Severity depends on which cervical vertebra is injured and the extent of the injury. An individual with an injury to C1 (the highest cervical vertebra) will likely be paralyzed and lose function from the neck down and be ventilator dependent. An individual with a C7 injury will likely be paralyzed and lose function from the chest down but still retain use of the arms and much of their hands. The extent of the injury is also important. A complete severing of the spine will result in complete loss of function from that vertebra down. A partial severing of the spinal cord results in varying degrees of mixed function and paralysis. For example, there are quadriplegics who have impairment in all four limbs but can still walk and use their hands due to the relatively minor extent of their injury.

Terminology
The condition is also termed tetraplegia. Both terms mean "paralysis of four limbs"; however, tetraplegia is becoming the more commonly accepted term for this condition.

"Tetra", like "plegia", has a Greek root, whereas "quadra" has a Latin root.

Incidence/prevalence
There are about 5000 cervical spinal cord injuries per year in the United States and about 1000 per year in the UK. In 1988, it was estimated that lifetime care of a 27-year-old rendered tetraparetic was about US $1 million and that the total national costs were US $5.6 billion per year.

Treatment/prognosis
Delayed diagnosis of cervical spine injury has grave consequences for the victim. About one in twenty cervical fractures are missed, and about two-thirds of these patients have further spinal cord damage as a result. About 30% of cases of delayed diagnosis of cervical spine injury develop permanent neurological deficits. In high cervical injuries total paralysis from the neck down is the result. Patients will need constant care and assistance in things such as getting dressed, eating, and bowel and bladder help. High quadriplegics will usually use catheters or wear diapers because they are unable to use their arms. Low quadriplegics (C6-C7) can usually live independently.

In some rare cases, through intensive rehabilitation, slight movement can be regained through "rewiring" neural connections as in the case of the late actor Christopher Reeve.

Support organizations

 * Back-Up Trust
 * MDAUSA
 * Spinal Cord Injury Peer Support
 * CareCure Community
 * European Multicenter Study about Spinal Cord Injury

Related conditions

 * hemiplegia
 * paraplegia
 * locked-in syndrome