quadriplegia

from Wikipedia, the free encyclopedia
Classification according to ICD-10
G82.5 Tetraparesis and tetraplegia, unspecified
ICD-10 online (WHO version 2019)

The Tetra Plegie (from ancient Greek τετρα- tetra , "four" and πληγή CARE , "shock, paralysis") is a form of paraplegia , are in all four limbs, so both legs affected and arms. The terms "quadriplegia" or "tetraparalysis" are also used less frequently. The result is a severe disability .

causes

The cause is usually severe damage to the spinal cord in the cervical area . It can be traumatic , caused by a tumor , an infectious or hereditary disease , inflammation of another origin or idiopathic :

consequences

With paraplegia, nerve lines in the spinal cord are interrupted. Electrical nerve impulses are sometimes no longer transmitted between the brain and other parts of the body. The result is: All those bodily functions that are controlled by areas of the spinal cord below the injury fail. A distinction is made between complete and incomplete paralysis. If the neurons are completely crushed or destroyed, there is no longer any function, both sensory and motor. Those affected feel neither pain nor touch or pressure. You cannot distinguish between hot and cold either.

Incomplete paralysis is present in 50% to 60% of cases. Motor or sensory control can still be fully or partially present even below the paralysis level. A severe impairment of the quality of life can be caused by pain or abnormal sensations in the border area of ​​the paralysis or below. These are described as burning, stabbing or throbbing and can occur permanently or only when irritated. More rarely, a bilateral failure of superordinate centers in the brain ( upper motor neuron , motor cortex ), for example due to a stroke , can trigger tetra paresis . Ultimately, this means a failure of the nerves innervating the arm and leg muscles ( brachial plexus , lumbosacral plexus ) and of the bladder , rectum and sexual function as well as a general loss of muscle control and sensitivity below the damage to the spinal cord.

The functional failures depend on the severity of the injury and the affected spinal cord segment. If the area of ​​the cervical spine (cervical cord; cervical vertebrae C1 to C7) is affected, both arms and legs are affected by paralysis. In the case of injuries above the 4th cervical vertebra (C4), the diaphragm is also paralyzed, which means that the affected person can only breathe with mechanical support.

In quadriplegia, the development of a functional hand is particularly important, because the person affected can no longer control the hand and finger functions. If the hand and fingers are not treated, deformations occur within three months and the hand and fingers would hardly be usable in everyday life. Grabbing something would be impossible. Tendons and ligaments are intentionally shortened to create a functional hand. This does not happen in an uncontrolled manner, but purposefully through a specific storage. Once the functional hand has been developed, the person affected can use it to grip things (e.g. a spoon or a pen). The flexor tendons of the fingers come under pressure when the wrist is actively stretched, i.e. the back of the hand is pulled up, and the hand closes into a fist. The fist grip is not tight, but it is sufficient to enable you to perform some very useful hand movements.

If there is an injury below the cervical vertebrae, known as paraplegia , those affected can still move their arms and hands, but the legs are paralyzed. If the spinal cord in the chest segment (thoracic cord; Th1 – Th8) is damaged, parts of the trunk muscles are also paralyzed. Statistically speaking, sexual function is less common in male quadriplegics and restricted to a lesser extent than in paraplegics (paralysis in the lower extremities). The term paraplegia is often used as a generic term that includes tetraplegia.

As a rule, a person with quadriplegia is dependent on care and assistance from other people.

Associations

Nonprofit Societies Dedicated to This Disease:

literature

  • Klaus Röhl: Cervical spine injuries with tetraplegia. In: Trauma and Occupational Disease , 2003, Vol. 5, No. 2, pp. 231-243, doi : 10.1007 / s10039-003-0736-x

Individual evidence

  1. ↑ Causes of cervical cord injuries. aerztezeitung.de; Retrieved April 9, 2011.
  2. ↑ Der-Querschnitt.de - information portal of the Manfred-Sauer-Foundation , accessed on 31 July 2020th
  3. ↑ Dr. med. Anita Kreilhuber: Paraplegia (paraparesis, paraplegia, tetraparesis, tetraplegia) . In: Netdoktor.at , March 2013, accessed on July 31, 2020.
  4. ↑ Training of a functional hand. In: Der-Querschnitt.de - information portal of the Manfred Sauer Foundation , accessed on July 31, 2020.
  5. ↑ Dr. med. Anita Kreilhuber: Paraplegia (paraparesis, paraplegia, tetraparesis, tetraplegia) . In: Netdoktor.at , March 2013, accessed on July 31, 2020.