Quadriplegia (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview
The spinal cord is part of the central nervous system, which allows the brain to communicate with the body. Quadriplegia is a type of spinal cord injury. Patients may become paralyzed because of spinal cord injure, or certain diseases such as tumor, cerebral palsy or stroke. Usual symptoms include difficult in breathing and moving the limbs, unable to feel anything below the damaged area, or feel pain in the arms, legs, back, and other areas, loss of control on bladder and bowel control. Medical history and neurologic examinations may supply the clues of diagnosis. Images in spinal cord and head may identify the damaded areas. Treatments need to start as soon as possible after diagnosis. Early treatment is very important for saving life and is related to the further quality of life. Treatment opinion of quadriplegia includes breathing assistant, surgery, medications and rehabilitation. Rehabilitation requires urgent emergency attention and ongoing care. Prognosis of quadriplegia varies from person to person.

What are the symptoms of Quadriplegia?
The symptoms of quadriplegia depends on the severity of the injury and the place it occurred. In general, injuries that are higher in your spinal cord produce more paralysis. Patients may experience one or more of the following signs or symptoms:
 * Difficult in moving the limbs
 * Unable to feel anything below the damaged area, or pain in the arms, legs, back, and other areas
 * Loss of control on bladder and bowel control
 * Difficult in breathing, or unable to breathe without help.

Who is at highest risk?

 * Spinal cord injury
 * Tumor affected spinal cord
 * Stroke
 * Cerebral palsy

When to seek urgent medical care?
When you feel quadriplegia, go to see your doctor as soon as possible.

Diagnosis

 * Medical history and physical examination
 * Neurologic examinations: Doctor may learn what area of your spinal cord is injured by this test.
 * Spine x-rays: X-rays help doctors see the structure of your spine and detect the part of the spine that is damaged.
 * Spinal cord CT scan: CT is a special x-ray machine that uses a computer to take pictures. CT scan can tell more detailed information on the areas that might be injured than general x-ray.
 * Spinal cord or head MRI (magnetic resonance imaging): An MRI uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces detailed images of the body. The test can show structure not only in spine, spinal cord, but also in muscles.

Treatment options
Treatments need to start as soon as possible after diagnosis. Early treatment is very important for saving life and is related to the further quality of life.
 * Assist breathing: If the patient is in difficult in breathing, he/she may be intubated to assist the breathing. This means that flexible tube carrying oxygen will be inserted down your throat.
 * Surgery: Surgery can not repair the damaged nerves of the spinal cord. The goal of the surgery is to relieve pressure on the spine from bone fragments, or to stabilize the spine.
 * Medications: Medications such as corticosteroid, methylprednisolone, may be used to reduce inflammatory reaction and prevent the spread of this damage if it is given within eight hours of the original injury.
 * Rehabilitation: The purpose of rehabilitation is to prevent further injury and enable people with a spinal cord injury to return to an active and productive life within the limits of their disability. Measurements of rehabilitation depend on the nature and severity of the patient's condition. It usually focuses on loss of functioning and feeling in certain areas of the body, loss or impairments in organ functioning. Rehabilitation requires urgent emergency attention and ongoing care.

Where to find medical care for Quadriplegia?
Directions to Hospitals Treating Quadriplegia

Prevention of Quadriplegia
Preventive measurements depends on the underlying cause.
 * Avoidance of trauma or traffic accidents
 * keep a healthy life style, control blood pressure and glucose, decrease the possibility of stroke
 * Health education and closely check during pregnant period, prevent birth injury.

What to expect (Outlook/Prognosis)?
Prognosis of quadriplegia depends on:
 * Underlying causes
 * The severity of injury in spinal cord or brain
 * Whether the patient is treated early
 * Whether the patient is accompanied with complications such as score and pneumonia