Quadriplegia and Paraplegia
Injury or disease to the nervous system can affect the ability to move a part of the body. This reduced motor ability is called paralysis.
- Paraplegia—paralysis of both legs
- Quadriplegia, sometimes called tetraplegia—paralysis of both legs and both arms
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Quadriplegia and paraplegia are most often caused by spinal cord injuries. But, they can also be caused by diseases, such as:
Most spinal cord injuries are caused by accidents, such as car crashes, falls, and sports injuries.
Whether it is paraplegia or quadriplegia depends on the location along the spine where the injury occurs:
- Paraplegia—damage below the neck
- Quadriplegia—damage to the spinal cord at the base of the skull or neck
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Factors that may increase your chance of quadriplegia and paraplegia include:
- Jobs or sports activities that increase your chances of spinal injury—high-risk sports such as football, rugby, wrestling, gymnastics, diving, surfing, ice hockey, and downhill skiing
- Family history of certain inherited nerve diseases
- History of cancer—can cause compression of the spinal cord
Paralysis due to spinal cord injuries may be total or partial. This depends on how much of the spinal cord is damaged. In addition to paralysis of the arms and/or legs, you may also suffer from:
- Incontinence —bladder or bowel
- Sexual dysfunction— male or female
- Trouble breathing
- Difficulty sitting upright depending on the level of the damage
Inactivity due to paraplegia and quadriplegia can cause additional problems, like:
People with paraplegia and quadriplegia may also become depressed because of:
- Social isolation
- Lack of emotional support
- Increased dependence on others
Diagnosis involves finding out where and how badly the brain and spinal cord are damaged. To do this, doctors will likely do the following tests:
Imaging tests evaluate the spine and other structures. These may include:
Your nerve function may be tested with:
- Nerve conduction study
- Somatosensory evoked potentials (SSEPs) (rarely used)
Your bodily fluids may be tested. This can be done with a lumbar puncture if some specific neurologic diseases are suspected.
Immediate treatment of spinal cord injuries includes bracing the bony spine to keep it from moving and further injuring the spinal cord. Steroids and other medications may be used to lessen damage to nerves and nearby tissue.
Recovery and rehabilitation usually begins in the acute care hospital setting. Depending on the cause and extent of the condition, this involves:
- Intensive physical therapy
During this time, patients are fitted for mobility aids, including wheelchairs. For most people, the majority of recovery happens within the first year.
The following measures are advised to reduce your chance of getting a spinal cord injury:
- Drive safely. Motor vehicle accidents are the leading cause of spinal cord injuries. Wear a seat belt every time you drive. Make sure your children wear seat belts or are in child safety seats. Don't drive if you have been drinking or using drugs.
- Be safe with firearms. Lock guns and ammunition in a safe place. Store them separately in locked containers.
- Take measures to avoid falls. Use a stool or stepladder to reach high places. Add handrails along stairways. Place nonslip mats in your bathroom, shower, and under carpets. To keep children safe, use safety gates to block stairs. Install window guards.
Always wear safety gear when playing sports. Avoid head-first moves, such as:
- Diving into shallow water
- Spear tackling in football
- Sliding headfirst in baseball
- Skating headfirst into the boards in ice hockey
- Use a spotter in gymnastics. Do not jump from very high places.
Christopher and Dana Reeve Foundation
Muscular Dystrophy Association
Canadian Paraplegic Association (Manitoba)
Binard JE. Care and treatment of spinal cord injury patients. J Am Paraplegia Soc. 1992;15(4):235-249.
Lukas RV, Chmura S, et al. Management of central nervous system metastases from renal cancer. Emerging Cancer Therapeutics. 2011;2(1):157-168.
Shakur S, Takagi I, et al. Ocular melanoma metastasis to the cervical spine: a case report. J Clin Neurosci. 2012;19(4):610-611.
Spinal cord injury—acute management. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114275/Spinal-cord-injury-acute-management. Updated June 15, 2017. Accessed November 8, 2017.
Spinal cord injury—chronic management. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T566521/Spinal-cord-injury-chronic-management. Updated September 7, 2017. Accessed November 8, 2017.
Last reviewed November 2018 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 12/20/2014