What is Quadriplegia?
Quadriplegia (also known as tetraplegia) is a form of paralysis. Unlike paraplegia (paralysis of the legs and lower trunk) or monoplegia (paralysis of a single limb), quadriplegia involves paralysis of the entire body from the neck down. Because the spinal cord is responsible for transporting electrical impulses to and from the brain, a damaged spinal cord prevents the brain from both receiving and transmitting these impulses.
Quadriplegia occurs when the spinal cord is damaged above the T1 vertebra (about the middle of the chest). Some quadriplegics are able to move their arms, but are unable to control the motions of their hands. Others are unable to move their necks or to breathe alone.
Quadriplegia involves paralysis of a large portion of the body, the quadriplegic is at risk of developing serious health complications. A quadriplegic may be unable to breathe alone during the first stages of the injury. Many quadriplegics must be placed on a ventilator to help them breathe. Some people are given a pacemaker to help stimulate the nerves of the diaphragm. Others learn to consciously breathe on their own. Quadriplegics are at greater risk of contracting respiratory infections than those who are not paralyzed. Because of this risk, many quadriplegics take medication and/or perform breathing exercises to help ward off infection.
The quadriplegic is unable to detect whether something touching them is too hot or too cold. The caregiver of a quadriplegic will need to be sure to check bath water before allowing the person to enter the tub. Electric blankets should be avoided, as well as heating pads and ice packs.
Pain in the Paralyzed Limbs
Quadriplegics often experience a pain similar to the “phantom pain” felt by amputees. While the paralyzed limb is unable to feel external sensations, it may continue to experience the sensation of pain within itself. Quadriplegics have described this pain as “burning,” “tingling,” “pins-and-needles” or “lightning bolts” of pain. Some quadriplegics suffer from the sensation of an insect crawling on the skin of a paralyzed body part. This type of discomfort is often treated by medication, chiropractics and physical therapy.
Autonomic dysreflexia is a life-threatening condition that often affects quadriplegics. A quadriplegic’s body may be able to sense pain or irritation in an area below the site of the paralysis, but this signal will not be able to reach the brain. The body will respond to this irritation by increasing the person’s blood pressure and lowering the heart rate. A person suffering from autonomic dysreflexia may experience: a pounding headache, nausea, sweating above the level of the injury and goose bumps below the level of the injury. Circumstances that can trigger autonomic dysreflexia include a full bladder or bowel, gastrointestinal disorders, pressure sores, sexual activity, tight clothing, injuries and abrupt temperature changes.
Rehabilitation for a Quadriplegic
The training and rehabilitation a quadriplegic receives following an injury is aimed at restoring mobility to the greatest degree possible and teaching the patient how to live with his or her limitations. Physical therapy is commonly used to help prevent muscle atrophy and to maintain healthy circulation. Other forms of rehabilitation include functional neuromuscular stimulation, or FNS. FNS uses electrical stimulation to activate the undamaged nerves in the paralyzed part of the body. These nerves cause the muscles to contract. Some quadriplegics are able to ride stationary bicycles using this stimulation to help retain muscle mass and stimulate circulation.