Paraplegia

Paraplegia is a condition that occurs when a person develops weakness of both legs because of a problem in the spinal cord or the nerves supplying the muscles of lower limbs, or due to a direct dysfunction of the muscles. Paraplegia results from a spinal cord injury below the first thoracic spinal nerve. A person with paraplegia loses the ability to walk, stand, or sit, with complete paralysis from the waist down, in some cases including loss of bladder and bowel control. Sometimes the paralysis reaches as high as the chest but the upper limbs are not affected. A diminished or complete absence of pain sensitivity or temperature regulation is experienced in the body’s affected area. Medical testing to diagnose paraplegia typically involves imaging of the spine with MRI, nerve conduction velocity studies, and/or electromyography (testing for electrical activity in muscles).

Paraplegia may be triggered by a number of causes: infections such as transverse myelitis, trauma to the spinal cord, spinal vertebrae fracture, or clots in the spinal cord blood vessels. These causes have been linked to sudden onset paraplegia. In other cases, paraplegia may be a more slowly evolving process, such as with tuberculosis, Guillain-Barre Syndrome, poliomyelitis, or tumors, to name a few. Children with spastic cerebral palsy may occasionally have paraplegia.

Paraplegia is a condition that occurs when a person develops weakness of both legs because of a problem in the spinal cord or the nerves supplying the muscles of lower limbs, or due to a direct dysfunction of the muscles.

Conventional Treatment

In addition to loss of bladder and bowel control, paraplegia complications may include loss of sensory and motor function and skin care issues. Treatment during the acute phase focuses on returning as much function as possible, with the first line of treatment being physiotherapy to improve the strength of the affected muscles. When a spinal cord injury is the cause of paraplegia, physiotherapy focuses on three common problems: weakness, contractures, and poor motor control. If the cause is linked to a treatable condition, such as tuberculosis or Guillain-Barre Syndrome, medication or intravenous immunoglobulin may be given. For demyelinating disorders, treatment with steroids may be initiated, and for trauma or fracture, bracing and surgery may be required to decompress the spine. If the child has difficulty passing urine or stool, then medical intervention may be required in the form of a urinary bladder catheter or enemas for constipation. Long-term treatment of paraplegia will focus on helping a child compensate for functional limitations and minimize complications. Mobility aids such as wheelchairs or crutches may be recommended. Recovery depends on the origin, extent of spinal cord damage, and the success of physiotherapy.