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Quadriplegia : Cause, Symptoms and Treatment

Quadriplegia is a neurological condition characterized by weakness in all four limbs (left arm, right arm, left leg, and right leg). Medically, quadriplegia is sometimes referred to as tetraplegia.

In quadriplegia, the muscles of the arms and legs are completely immovable, or even unable to contract at all. Not infrequently, disorders to resist urination and defecation also occur. The condition of quadriplegia can be temporary, but can also be permanent. But more often this disorder occurs permanently.

Causes of Quadriplegia

In general, quadriplegia results from a disruption in the spinal cord. There are many disease conditions that can cause it, including:

  • Infection that attacks the spinal cord, such as polio infection

Polio is a viral infectious disease that affects more children under five. Transmission through food or water contaminated with polio virus. Apart from polio, other infections that can cause quadriplegia are infections of flavivirus, enterovirus, hepatitis C, HIV, and Epstein Barr virus.

  • Genetic disorders such as Duchene Muscular Dystrophy (DMD)

DMD is a genetically inherited disease that causes symptoms in boys. DMD is characterized by weakness in the muscles of the arms and legs that are getting heavier and longer, until finally they cannot be moved at all.

  • Spinal cord injury (spinal cord trauma)

Spinal cord injuries are often triggered by accidents, falls, or the effects of surgery on the spinal region. In this condition, quadriplegia occurs suddenly.

  • 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 for the occurrence of this disease is unclear. But in general before quadriplegia occurs, the sufferer experiences coughing cold 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 is burdensome when on the move.

  • Poisoning

Intoxication of certain substances can cause paralysis of the hands and feet. Some of the substances that can cause it are alcohol, snake venom, scorpion bites, botulinum infections that can be found in contaminated canned food, and certain types of chemotherapy drugs.

  • Tumor

Both benign tumors and malignant tumors that attack the spine, or tumors from other organs that spread to the spine, can cause quadriplegia. Usually quadriplegia is caused because the tumor slowly occurs.

Diagnosis of Quadriplegia

To confirm the diagnosis of quadriplegia, there are various checks that need to be done. As a preliminary examination, the doctor will conduct an interview, a thorough physical examination, and a nerve 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 stool examination to isolate the virus. If it is suspected that the cause is a spinal cord injury or tumor, then a magnetic resonance imaging (MRI) examination of the spine is needed to determine the location details of the abnormality and the severity of the abnormality experienced.

If the cause is GBS or myasthenia gravis, then an examination of muscle strength through electromyography (EMG) needs to be done. Examination of brain fluid analysis through lumbar puncture also sometimes needs to be done to ensure the presence or absence of GBS.

Symptoms of Quadriplegia

The main symptoms of quadriplegia are weakness in the left arm, right arm, left leg, and right leg. Unlike the condition of quadriparesis (a milder form of quadriplegia), in the quadriplegia, the muscles of the arms and legs cannot contract at all. These weaknesses can cause the limbs and arms to become sluggish or stiff. Sometimes quadriplegia is also accompanied by symptoms of bedwetting and cannot resist defecation.

In more detail, the symptoms that accompany quadriplegia vary depending on the disease that causes it. If it is caused by polio, the initial symptoms that arise are fever, headache, vomiting, stiff neck, then continued with the emergence of sudden quadriplegia.

Quadriplegia caused by DMD, appears from infancy and only causes symptoms in boys. Initial muscle weakness is only a mild weakness, over time it becomes more severe until the sufferer cannot stand and walk.

Quadriplegia because GBS is preceded by diarrhea or cold cough. Then symptoms of tingling or numbness arise in the palms and legs that radiate upward, accompanied by weakness in the arms and legs. In severe conditions, GBS can cause severe breathlessness that can lead to death.

Quadriplegia due to MG is characterized by typical symptoms of weakness of the arms and legs after heavy activity, and will improve after the sufferer has rested. In addition, the eyelids of MG sufferers will go down and be difficult to lift if a lot of activity, and will become normal again in the morning after resting.

Quadriplegia caused by the tumor slowly and progressively. Whereas quadriplegia due to spinal cord injury occurs suddenly.

Treatment of Quadriplegia

Quadriplegia treatment varies greatly depending on the cause. Quadriplegia caused by polio and DMD cannot be cured. Efforts can be made to do medical rehabilitation in the form of physiotherapy and physical exercise so that the muscles do not shrink due to the paralysis experienced.

In quadriplegia caused by a spinal cord injury, treatment as soon as possible by a neurologist at the hospital is very important. In order for the injury to be recovered, the drug in the form of high-dose corticosteroids must be given immediately in less than 8 hours after the injury occurs.

GBS is treated with anti-inflammatory drugs, corticosteroids. If you don't get better with the drug, the doctor will consider treatment with intravenous immunoglobulin. Meanwhile, quadriplegia that occurs due to myasthenia gravis is generally treated with pyridostigmine or neostigmine.

If quadriplegia occurs because of a tumor, the treatment can be surgery, chemotherapy, or radiation, depending on the type of tumor that attacks the spine.

Prevention of Quadriplegia

Most cases of quadriplegia cannot be prevented. One of the preventable quadriplegia is quadriplegia caused by polio. Prevention is to do polio immunization on schedule since the baby is born.

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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.