• Tetraplegia


Quadriplegia (or Tetraplegia) is the partial or complete paralysis of both arms and legs. The spinal cord and the brain are the main parts of the central nervous system, which sends messages throughout the body. The spinal cord is the nerve system encased in the vertebrae and discs that comprise the spine. The primary cause of quadriplegia is spinal cord injury. Spinal cord injury resulting in quadriplegia can occur at any age, including at birth or after cervical spine trauma in later childhood. Quadriplegia occurs when the neck area of the spinal cord is injured and the brain is unable to properly communicate through it; therefore, sensation and movement are impaired. The location of the spinal cord injury and the extent of damage determine the resultant level of impairment.

Conditions such as cerebral palsy can cause similar paralysis. Spastic quadriplegia/spastic tetraplegia is a subcategory of spastic cerebral palsy that affects all four limbs. It is generally caused by brain injury either before, during, or shortly after birth, and can result from many factors such as fetal infections, maternal infections, exposure to toxins, or medical negligence. Spastic tetraplegia affects the entire body and causes spasticity of the limbs rather than the strict paralysis associated with complete quadriplegia. It is different from other forms of cerebral palsy as those with spastic quadriplegia display stiff, jerky movements stemming from abnormally high levels of muscle tone or tension of the muscles.

Spinal cord injury resulting in quadriplegia can occur at any age, including at birth or after cervical spine trauma in later childhood.

Conventional Treatment

Whatever the cause, quadriplegia is associated with many complications, with some subsequent or tertiary complications needing long-term management: loss of bladder and bowel control that can lead to urinary tract infections and/or constipation, pressure sores on the skin caused by extended periods of immobility, blood clots from lack of bodily movement, respiratory problems due to weakened nerve signals to the chest and diaphragm, muscle spasms, and pain, among others. Therapeutic treatment options include physical, occupational, and speech therapy. Pharmaceutical and, less frequently, surgical interventions may also be recommended. 

Spastic quadriplegia symptoms often include rapid contraction and release of muscles, muscle tightness and tremors, joint rigidity, speech and language impediments, inability to walk, and cognitive concerns. In a child with spastic quadriplegia, spasticity may inhibit motor function, contribute to spinal deformity, and make comfort and care more difficult. Spasticity interventions are aimed at improving comfort, reducing pain, educating and assisting caregivers, and slowing the progression of musculoskeletal deformities such as scoliosis, with improved function as a primary goal. Current treatment options include botulinum toxin, oral medications, and orthopedic surgery, just to name a few. Management programs must account for the child’s age and nutrition, progression of musculoskeletal deformity, level of functioning, developmental potential, as well as the child’s and family’s goals. The integration of these and other treatment options can help improve the overall care and function of a child with spastic quadriplegia.