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Jai Ganesh

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Registered: 2005-06-28

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Paraplegia

Paraplegia

Gist

Paraplegia is a term used to describe the inability to voluntarily move the lower parts of the body. The areas of impaired mobility usually include the toes, feet, legs, and may or may not include the abdomen. Picture: A person with a complete T12 level of injury is paralyzed from the waist down.

Summary

Paraplegia, or paraparesis, is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek "half-stricken". It is usually caused by spinal cord injury or a congenital condition that affects the neural (brain) elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If four limbs are affected by paralysis, tetraplegia or quadriplegia is the correct term. If only one limb is affected, the correct term is monoplegia. Spastic paraplegia is a form of paraplegia defined by spasticity of the affected muscles, rather than flaccid paralysis.

The American Spinal Injury Association classifies spinal cord injury severity in the following manner. ASIA A is the complete loss of sensory function and motor skills below the injury. ASIA B is having some sensory function below the injury, but no motor function. In ASIA C, there is some motor function below the level of injury, but half of the muscles cannot move against gravity. In ASIA D, more than half of the muscles below the level of injury can move against gravity. ASIA E is the restoration of all neurologic function.

Treatment

Individuals with paraplegia can range in their level of disability, requiring treatments to vary from case to case. Rehabilitation aims to help the patient regain as much functionality and independence as possible. Physiotherapy may help to improve strength, range of motion, stretching and transfer skills. Most paraplegics will be reliant on a wheelchair as a mode of transportation. Activities of daily living (ADLs) can be quite challenging at first for those with a spinal cord injury (SCI). With the aid of physiotherapists and occupational therapists, individuals with an SCI can learn new skills and adapt previous ones to maximize independence, often living independently within the community.

Regeneration of the spinal cord

Olfactory ensheathing cells (OEC) have been transplanted with success into the spinal cord of Polish man named Darek Fidyka, who was the survivor of a knife attack that left him paraplegic in 2010.

In 2014, Fidyka underwent pioneering spinal surgery that used nerve grafts, from his ankle, to 'bridge the gap' in his severed spinal cord and OEC's to stimulate the spinal cord cells. The surgery was performed in Poland in collaboration with Prof. Geoff Raisman, chair of neural regeneration at University College London's Institute of Neurology, and his research team. The olfactory cells were taken from the patient's olfactory bulbs in his brain and then grown in the lab, these cells were then injected above and below the impaired spinal tissue.

Fidyka regained sensory and motor function in his lower limbs, notably on the side of the transplanted OEC's. Fidyka first noticed the success three months after the procedure, when his left thigh started gaining muscle mass. MRIs suggest that the gap in his spinal cord has been closed up. He is believed to be the first person in the world to recover sensory function from a complete severing of the spinal nerves.

Details

Paraplegia is paralysis of the legs and lower part of the body. Paraplegia often involves loss of sensation (of pain, temperature, vibration, and position) as well as loss of motion. It may also include paralysis of the bladder and bowel. Paraplegia may be caused by injury to or disease of the lower spinal cord or peripheral nerves or by such brain disorders as cerebral palsy. Some paraplegics are able to walk with the aid of braces and crutches. Quadriplegia involves paralysis of both arms and both legs. Respiration may also be affected if the upper cervical region of the spinal cord is damaged.

Additional Information

About 1 in 50 Americans lives with some form of paralysis. Paraplegia is a type of paralysis that affects the lower half of your body and your ability to walk. It is often caused by injury.

There is no cure for paraplegia but there are many treatments that can make it easier to manage.

What is paraplegia?

Paraplegia is a type of paralysis that affects your ability to move the lower half of your body. It occurs when an illness or injury impacts the part of your nervous system which controls the lower half of your body.

You might have trouble moving your legs, feet, and stomach muscles. In some cases, this paraplegia will only affect one leg. This is called incomplete paraplegia.

How is it different from other forms of paralysis?

Different forms of paralysis are named for the areas of the body and how much of the body they impact. Paraplegia only impacts the lower half of the body. Other forms of paralysis include:

* Monoplegia. This type impacts only one limb.
* Paraparesis. This type partially impacts both legs.
* Diplegia. This type impacts either both arms or both legs.
* Hemiplegia.This type impacts one side of the body. For example, your left arm and left leg.
* Quadriplegia. This type impacts both arms and both legs. Quadriplegia is sometimes referred to as tetraplegia.

What are the symptoms of paraplegia?

The symptoms of paraplegia can depend on the person and on the severity of your paraplegia. Some symptoms will be present right away and others might develop over time.

Symptoms include:

* loss of feeling in the lower half of your body
* chronic pain
* phantom pain in the lower half of your body
* bladder and bowel trouble
* difficulty walking and standing
* weight gain
* depression
* coitus difficulties
* skin breakdowns
* infections
* high blood pressure

How is paraplegia diagnosed?

A medical provider can assess you for paraplegia if you’re having symptoms. They’ll take a detailed medical history that will include any recent accidents or illnesses.

You’ll generally need medical imaging tests to look for damage that might be causing your symptoms. Imaging tests include an MRI, X-ray, or CT scan. You might also have a test called electromyography. This test measures how your body responds when affected muscles are stimulated.

What causes paraplegia?

Paraplegia is normally caused by injury to your spinal cord or brain that stops signals from reaching your lower body. When your brain cannot send signals to your lower body, it results in paralysis.

Many injuries that cause paraplegia are the result of accidents. Accidents that might cause paraplegia include:

* car accidents
* falls
* sports accidents
* being the victim of a crime

Sometimes paraplegia is caused by conditions that damage your spinal cord and brain. These can include:

* cerebral palsy
* cancer
* nerve conditions
* multiple sclerosis
* stroke
* spinal tumors
* brain tumors
* hereditary spastic paraplegia, a rare genetic condition

Can you prevent paraplegia?

Unfortunately, most cases of paraplegia are caused by accidents and conditions that aren’t preventable.

You can take steps to reduce your risk of accidents, such as practicing safe driving. However, there is no way to prevent all accidents and completely prevent any chance of paraplegia.

What are common risk factors for developing paraplegia?

There are a few risk factors for developing paraplegia. These include:

* playing high-impact sports such as football or wrestling
* participating in sports like gymnastics, diving, or surfing
* a history of cancer
* a family history of a condition that affects your nervous system

Finding care for paraplegia

If you or a loved one have paraplegia, these organizations can help find the care and support you need:

* The Christopher & Dana Reeve Foundation. This foundation has a support line (800-539-7309) for free help finding physicians, rehabilitation facilities, therapists, and more.

* The United Spinal Association. This association can connect you with support groups, accessibility resources, and more.

* FacingDisability.com. This organization can help you find medical care, financial assistance, disability advocacy, assistive technology, and more.

Was this helpful?

How is paraplegia treated?

There is no way to cure paraplegia. However, in some cases, people are able to regain some control over the affected areas. Additionally, treatments can help you manage the symptoms of paraplegia.

Treatment options for paraplegia include:

* Physical therapy. This type of therapy helps reduce pain, build strength in surrounding muscles, and prevent muscle deterioration.

* Occupational therapy. This therapy helps individuals with paraplegia adapt to completing daily tasks.

* Mobility devices. These include assistance devices such as wheelchairs and power scooters to help individuals improve and maintain mobility.

* Prescription medications. These include medications such as muscle relaxers and pain relievers to help with pain, blood thinners to reduce your risk of clots, and others.

* Surgery. Different surgical procedures may help to treat symptoms, address mobility, and improve health.

Treatment will depend on your case and symptoms. It might also change over time. There is no cure for paraplegia, but with help, you can manage your condition.

What’s the outlook for people with paraplegia?

Paraplegia is a lifelong condition that can lead to other issues with time. This might include:

* overactive muscle responses called spasticity
* trouble with digestion
* constipation or loose bowels
* incontinence
* muscle weakness
i* nfections

Over time, paraplegia can lead to a decline in a person’s function and independence as symptoms become worse. Your medical team will help you reduce these possible complications. If they do develop, you might need additional medications or treatments.

The bottom line

Paraplegia is a type of paralysis that affects the lower half of your body. It affects your ability to walk, stand, and do other actions that require control of your legs, feet, pelvic muscles, and stomach.

Paraplegia is generally the result of an injury, but it can also be caused by conditions that damage your spinal cord or brain. There is no cure for paraplegia, but treatment can help you manage your condition.

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