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Paraplegia

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(Paralysis; Loss of Movement)

Definition

Paraplegia is the word used to describe the body's loss of movement and/or feeling as a result of an injury to the nervous system. Paraplegia is complete or partial paralysis of the lower half of the body.
Some patients may resume some function. Many patients with paraplegia may have long term loss of function.
Paraplegia
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Causes

Injury to the nervous system is the most common cause of paraplegia. Common injuries and other causes include:
  • Broken neck
  • Broken back
  • Stroke
  • Spinal cord injury
  • Genetic disorder (hereditary spastic paraplegia)
  • Congenital (present at birth)
  • Infection
  • Autoimmune diseases
  • Tumor (either within the spinal cord or pushing on the spinal cord)
  • Syrinx (a spinal cord disorder)

Risk Factors

Paraplegia is often the result of an accident. People who participate in high-risk or high-contact sports or those who drive recklessly may be at greater risk.

Symptoms

Symptoms will depend on how much of the spinal cord is involved. Symptoms include:
  • Loss of movement or muscle control in the legs, feet, toes, or trunk
  • Loss of feeling in the legs, feet, toes, or trunk
  • Tingling in the legs, feet, toes, or trunk
  • Loss of bowel and bladder control
  • Sexual difficulties

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Neurosurgeons, orthopedists, and neurologists are involved in diagnosis after a paralytic injury has occurred.
Your doctor may need to view your spine. This can be done with:
Your doctor may need to test your body fluids. This can be done with:
An evoked potential nerve test may also be done to evaluate the nerve's pathways.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Emergency Medical Treatment

If you have an injury that causes paraplegia, emergency treatment is needed to prevent further damage to the nervous system. An evaluation will be done to determine the amount of damage. The doctor will decide what therapies are needed to prevent further injury and improve recovery. Steroids may be used to reduce the swelling of the spinal cord if it has been injured. Surgery may be done to help stabilize or relieve pressure on the spine. Surgery may be needed if a tumor is pushing on the spinal cord. Radiation therapy is another treatment option.

Therapy and Rehabilitation

In most patients, physical therapy and rehabilitation may help restore muscle function. Occupational and speech therapy may also be helpful.

Prevention

Paraplegia is most often caused by injury or accident. The chance of injury resulting in paraplegia may be reduced by paying careful attention to environmental factors. Using safety equipment when playing sports and wearing seatbelts when driving will help reduce the chance that an accident will cause serious injury. You can also reduce these chances by avoiding risk-taking activities, like driving while under the influence or driving when tired.

RESOURCES

Christopher and Dana Reeve Foundation http://www.christopherreeve.org/

Spastic Paraplegia Foundation http://www.sp-foundation.org/

CANADIAN RESOURCES

Canadian Paraplegic Association (Alberta) http://www.cpa-ab.org

Health Canada http://www.hc-sc.gc.ca

References

Alisky JM, Nogo A. Protein neutralisation and motor cortex computer implants: a future hope for spinal cord injury [review]. Singapore Med J. 2007;48:596-597.

Faden AI, Stoica B. Neuroprotection: challenges and opportunities [review]. Arch Neurol. 2007;64:794-800.

Kruszewski SP, Shane JA. Pregabalin in central neuropathic pain associated with spinal cord injury: a placebo-controlled trial. Neurology. 2007;68:2158-2159.

Penas-Prado M, Loghin ME. Spinal cord compression in cancer patients: review of diagnosis and treatment. Curr Oncol Rep . 2008;10:78-85.

Sharma HS. Neurotrophic factors in combination: a possible new therapeutic strategy to influence pathophysiology of spinal cord injury and repair mechanisms [review]. Curr Pharm Des. 2007;13:1841-1874.

Shimizu H, Yozu R. Current strategies for spinal cord protection during thoracic and thoracoabdominal aortic aneurysm repair. Gen Thorac Cardiovasc Surg . 2011;59(3):155-163.

Spinal cord injury information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/sci/sci.htm . Updated September 18, 2012. Accessed November 28, 2012.

What is paraplegia? Spinal Injury Network website. Available at: http://www.spinal-injury.net/paraplegia.htm . Accessed November 28, 2012.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 11/2012 -
  • Update Date: 11/28/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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