Quadriplegia Definition, Reason, Symptoms, Treatment & Prevention
Quadriplegia Definition
Quadriplegia is a condition of a nervous disorder characterized by weakness in all four limbs (left arm, right arm, left leg and right leg). Quadriplegia is medically sometimes referred to as tetraplegia.
In quadriplegia, the muscles in the arms and legs are completely immovable, or even unable to contract at all. Not infrequently, interference with holding back urination and defecation also occurs. Quadriplegia conditions can be temporary, but can also be permanent. But more often this disorder occurs sedentary.
Quadriplegia Symptom
The main symptom of quadriplegia is weakness in the left arm, right arm, left leg, and right leg. In contrast to the condition of quadriparesis (a milder form of quadriplegia), in quadriplegia, the arm and leg muscles cannot contract at all. This weakness can cause the legs and arms to become sluggish or stiff. Sometimes quadriplegia is also accompanied by symptoms of incontinence and inability to hold bowel movements.
In more detail, the symptoms that accompany quadriplegia vary, depending on the disease that causes it. If caused by polio, the initial symptoms that arise are fever, headache, vomiting, stiff neck, followed by the sudden appearance of quadriplegia.
Quadriplegia, caused by DMD, is present in infancy and only causes symptoms in boys. Initially, muscle weakness is only mild weakness, gradually it gets worse so that the sufferer cannot stand and walk.
Quadriplegia due to GBS is preceded by diarrhea or a cold cough. Then symptoms of tingling or numbness appear in the palms of the hands and feet that radiate upwards, accompanied by weakness in the arms and legs. In severe circumstances, GBS can cause sufferers of severe shortness of breath which can lead to death.
Quadriplegia due to MG is characterized by typical symptoms, namely weakness in the arms and legs that gets worse after strenuous activity, and will improve after the sufferer rests. In addition, the eyelids of people with MG will droop and be difficult to lift if they do a lot of activity, and will return to normal in the morning after resting.
Quadriplegia caused by a tumor occurs slowly and progressively. Meanwhile, quadriplegia due to spinal cord injury occurs suddenly.
Quadriplegia Reason
In general, quadriplegia occurs due to interference with the spinal cord. There are many disease conditions that can cause it, including:
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Infections that attack the spinal cord, for example, polio infection
Polio is a viral infection that mostly affects children under five. Transmission through food or water contaminated with the polio virus. Apart from polio, other infections that can cause quadriplegia are flavivirus, enterovirus, hepatitis C, HIV, and Epstein-Barr virus infections.
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Genetic disorders such as Duchene Muscular Dystrophy (DMD)
DMD is a genetically inherited disease, which causes symptoms in boys. DMD is characterized by muscle weakness in the arms and legs that gets progressively worse until finally you can’t move at all.
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Spinal cord injury (spinal cord trauma)
Spinal injuries are often triggered by accidents, falls, or the impact of surgery in the spinal area. In this condition, quadriplegia occurs suddenly.
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Autoimmune diseases such as Guillain-Barre syndrome and myasthenia gravis
Gullain-Barre syndrome (GBS) is an autoimmune disease that attacks the spinal cord. The mechanism by which this disease occurs is not clear. But in general, before quadriplegia occurs, the sufferer experiences a cold cough or diarrhea.
Meanwhile, myasthenia gravis (MG) is an autoimmune disease that attacks the connection between nerves and muscles. Muscle weakness in MG is characterized by muscle weakness that gets worse during activities.
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Poisoning
Poisoning (intoxication) of certain substances can cause paralysis of the hands and feet. Some substances that can cause it are alcohol, snake venom, scorpion bites, botulinum infections which can be found in contaminated canned food, and some types of chemotherapy drugs.
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Tumor
Both benign tumors and malignant tumors that invade the spine, or tumors from other organs that spread to the spine, can cause quadriplegia. Usually, quadriplegia caused by a tumor occurs slowly.
Diagnosis
To confirm the diagnosis of quadriplegia, there are various tests that need to be done. As an initial examination, the doctor will conduct interviews, a thorough physical examination, and a neurological examination.
If polio is suspected to be the cause, it is necessary to do a blood test to assess the presence of antibodies to the polio virus and a stool examination to isolate the virus. If a spinal injury or tumor is suspected, a magnetic resonance imaging (MRI) examination of the spine is needed to find out the details of the location of the abnormality and the severity of the abnormality experienced.
If the cause is GBS or myasthenia gravis, then checking muscle strength through electromyography (EMG) needs to be done. Examination of cerebrospinal fluid analysis through lumbar puncture also sometimes needs to be done to ensure the presence or absence of GBS.
Quadriplegia Treatment
Treatment for quadriplegia varies widely, depending on the cause. Quadriplegia caused by polio and DMD cannot be cured. Efforts that can be made are medical rehabilitation in the form of physiotherapy and physical exercises so that the muscles do not shrink due to paralysis.
In quadriplegia caused by spinal cord injury, treatment as soon as possible by a neurologist in a hospital is very important. In order for the injury to recover, drugs in the form of high-dose corticosteroids must be given immediately in less than 8 hours after the injury occurred.
GBS is treated with anti-inflammatory drugs, namely corticosteroids. If it doesn’t get better with these drugs, the doctor will consider treatment with intravenous immunoglobulin. Meanwhile, quadriplegia that occurs due to myasthenia gravis is generally treated with pyridostigmine or neostigmine drugs.
If quadriplegia occurs due to a tumor, then the treatment can be surgery, chemotherapy, or radiation, depending on the type of tumor that attacks the spine.
Prevention
Most cases of quadriplegia can’t be prevented. One of the preventable quadriplegias is quadriplegia caused by polio. Prevention is by carrying out polio immunization according to the schedule since the baby is born.