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Paraplegia

(Paralysis; Loss of Movement)

Definition

Paraplegia is a complete or partial loss of movement or feeling in the lower half of the body.
Paraplegia
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Causes

Paraplegia happens when there is damage below the neck. The most common cause is trauma, such as from a sports injury or car accident. Other causes are:
  • Stroke
  • Genetic disorder (hereditary spastic paraplegia)
  • Congenital (present at birth)
  • Infection
  • Problems with the immune system
  • Tumor within the spinal cord or pushing on the spinal cord
  • Syrinx (a spinal cord disorder)

Risk Factors

This problem is more common in people who play contact sports.

Symptoms

The problems a person has will depend on how much of the spinal cord is affected. A person may have:
  • 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 problems

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. Neurosurgeons, orthopedists, and neurologists will be involved in the diagnosis.
Blood tests will be done. The fluid around the brain and spine may also be tested. This can be done with a lumbar puncture.
Images may need to be taken of the spine. This can be done with:
Nerve function may be tested. This can be done with:

Treatment

Emergency care will be needed. It can prevent further damage to the nervous system. It may also include:
  • Steroids to ease swelling of the spinal cord
  • Surgery to stabilize the spine or ease pressure on it

Therapy

Therapy will be needed to improve function and quality of life. Choices are:
  • Physical therapy—to improve movement and learn how to use assistive devices
  • Occupational therapy—to help with daily tasks and self care
  • Speech therapy—to improve swallowing and speech
  • Psychological therapy—to provide support

Prevention

Paraplegia is often due to accidents that cannot be prevented.

RESOURCES

Christopher and Dana Reeve Foundation
http://www.christopherreeve.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES

Health Canada
https://www.canada.ca
Spinal Cord Injury Canada
http://sci-can.ca

References

Eckert MJ, Martin MJ. Trauma: Spinal Cord Injury. Surg Clin North Am. 2017 Oct;97(5):1031-1045.
Management of chronic spinal cord injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-chronic-spinal-cord-injury. Accessed January 27, 2021.
Spinal cord injury information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Spinal-Cord-Injury-Information-Page. Accessed January 27, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 12/2020
  • Update Date: 01/27/2021
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