Paraplegia and quadriplegia are two types of paralysis that often result from spinal cord injuries.
According to 2013 estimates, nearly 5.4 million people in the United States live with paralysis.
Paraplegia refers to the loss of movement and sensation in both legs and, sometimes, part of the lower abdomen. Quadriplegia affects all four limbs and, in some people, parts of the chest, abdomen, and back.
In this article, we describe both types of paralysis, including their causes and treatment options.
Paraplegia and quadriplegia are forms of paralysis, which is the partial or complete loss of movement in one or more parts of the body. There are numerous causes of paralysis, including neuromuscular diseases, spinal cord injuries, and stroke.
Paralysis can present in many different forms, depending on the underlying cause and the severity of the damage. Types of paralysis include:
Paraplegia refers to complete or partial paralysis in both legs and, in some people, parts of the lower abdomen.
People sometimes use the term “paraplegia” interchangeably with “paraparesis,” which is partial paralysis in the lower body due to muscle weakness and stiffness.
Quadriplegia, which some people refer to as tetraplegia, is paralysis that results in the loss of movement and sensation in all four limbs. It can also affect the internal organs in the trunk.
Some other forms of paralysis include monoplegia, which affects one arm, and hemiplegia, which affects one leg and one arm on the same side of the body.
Damage to the brain or spinal cord can cause paraplegia or quadriplegia.
Spinal cord injury
Every year, 250,000–500,000 spinal cord injuries occur around the world. The spinal cord is a long, tube-like structure. It consists of bundles of nerve fibers that relay signals between the brain and the rest of the body.
The bones of the spine — the vertebrae — protect the spinal cord from physical injury. However, a blow or a fall can break or dislocate a vertebra, damaging a segment of the spinal cord.
The resulting inflammation can destroy the myelin sheath that surrounds nerve fibers. Nerves with damaged sheaths cannot transmit electrical signals as quickly or efficiently as usual.
The effects of a spinal cord injury vary depending on where the damage occurs. For instance, an injury to the sacral or lumbar regions in the lower back may cause paralysis in the legs and the lower portion of the abdomen.
An injury involving the thoracic spinal nerves in the upper back can cause paralysis or weakness in the chest, abdomen, and legs.
The term “cervical spinal cord” refers to the spinal cord in the neck. Injuries to this area can cause paralysis of the entire body below the neck.
Motor vehicle accidents and falls are usually responsible for trauma that breaks or crushes the vertebrae, injuring the spinal cord.
If, instead, a health problem, such as a spinal stroke, arthritis, cancer, infection, or disk degeneration, is the cause of damage to the spinal cord, doctors refer to this as a nontraumatic spinal cord injury.
A stroke occurs when narrowed, blocked, or broken blood vessels interrupt the supply of blood to the brain and, less commonly, the spinal cord. Without an adequate amount of oxygen-rich blood, brain cells begin to die, leading to paralysis.
Paralysis due to a stroke usually affects one side of the body. However, damage to the lower portion of the brain that connects to the spinal cord can cause muscle weakness or paralysis on both sides.
Some other symptoms of stroke include:
- a sudden, severe headache
- vision problems
- dizziness or loss of balance
- difficulty walking
- difficulty speaking
Cerebral palsy refers to a group of neurological disorders that affect the outer layer of the brain, called the cerebral cortex, which controls muscle movement.
Depending on the location and severity of the damage, cerebral palsy may cause:
- coordination problems
- muscle stiffness
- involuntary movements, such as tremors or spasms
- paraplegia or quadriplegia
Multiple sclerosis (MS)
MS is an inflammatory disorder that attacks the myelin sheath covering nerve fibers in the brain, spinal cord, and optic nerves.
MS causes a wide variety of symptoms that range from mild numbness to significant muscle weakness that alters a person’s gait.
Other symptoms include:
- chronic pain
- muscle spasms in the legs
- prickling or a pins-and-needles sensation in the face, body, or limbs
- the feeling of an electric shock running from the back of the neck into the arms or legs, which is called Lhermitte’s sign
- loss of coordination or dizziness
Severe forms of MS can cause partial or complete paralysis, although this only occurs in about one-third of MS cases. Most people with MS can walk, though many require an aid, such as a cane or crutches.
Other possible causes of paralysis include:
- a blood clot or tumor on the spinal cord
- rheumatoid arthritis that causes inflammation at the top of the spine
- spinal cord infections, for example, due to polio, HIV, West Nile virus, or syphilis
- inherited disorders, such as hereditary spastic paraplegia or Andersen-Tawil syndrome
- neurodegenerative disorders, such as amyotrophic lateral sclerosis — also known as motor neuron disease or Lou Gehrig’s disease
Paralysis can have significant long-term effects on a person’s physical health, independence, and overall quality of life.
Challenges of paraplegia
A person with paraplegia may have limited mobility and sensation in the legs. However, they retain their neurologic function in the upper body.
An individual with this form of paralysis can often live independently and perform tasks such as eating and dressing without assistance.
Some people with paraplegia can walk with leg braces and crutches, while others use manual wheelchairs. However, manual mobility devices put stress on the upper body, which can damage the joints in the wrists and shoulders over time.
Paraplegia can affect the sensory nerves, causing numbness or hypersensitivity. As a result, a person with paraplegia may not notice injuries to their legs, or they may experience painful burning or tingling sensations in their lower body.
Someone with paraplegia may also experience:
- chronic pain
- a rapid heartbeat
- high blood pressure
- reduced bladder and bowel function
- sexual dysfunction
- weight gain
Challenges of quadriplegia
Quadriplegia affects the body from the neck down, which can significantly reduce a person’s independence.
Depending on the extent of the paralysis, a person with quadriplegia may experience:
- limited or complete absence of arm and hand function
- problems speaking, swallowing, or breathing without assistance
- difficulty performing daily tasks, such as bathing, dressing, and eating
- difficulty moving from a bed or wheelchair without assistance or the use of a device
- pressure ulcers, also known as pressure sores or bedsores
- bone and muscle loss
Paralysis is not curable, but it is possible for some people to regain partial or complete control over affected areas in time.
Available treatments can currently:
- reduce the long-term effects of central nervous system damage
- slow any disease progression
- prevent and manage additional complications
- improve a person’s quality of life
Medical treatments for paraplegia and quadriplegia include:
Doctors may use emergency surgical procedures to treat primary causes of central nervous system damage, such as:
- blocked or bleeding arteries
- swelling around the brain or spinal cord
- fractured or dislocated vertebrae
- tumors on the spinal cord
Doctors may recommend surgery if a person develops complications of paralysis, such as pressure ulcers, muscle damage, or chronic pain.
Doctors may prescribe the following medications:
- antibiotics, to lower the risk of infection
- corticosteroids, to reduce nerve inflammation
- blood thinners, to prevent blood clots
Rehabilitation is an essential part of the recovery process.
Physical therapy focuses on regaining muscle function and strength through repetitive movements. Physical therapists can recommend specific exercises and strategies for staying physically active.
Speech therapy can help people regain or maintain their ability to speak, while occupational therapy involves learning to balance self-care and work.
Coping and support
Paralysis can significantly alter a person’s quality of life. In a 2016 study, researchers evaluated the quality of life of 84 people with traumatic paraplegia. They conducted a face-to-face interview with each participant and asked them to complete a questionnaire.
Compared with the general population, the study participants had lower scores for physical health, psychological well-being, and social relationships. However, the study cohort was not representative of the general population, as more than 90% of the participants were male.
People with paraplegia or quadriplegia may benefit from:
- learning about the various treatment and rehabilitation options
- making changes that increase mobility, such as installing adaptive aids around the house
- asking for help without hesitation from family, friends, and healthcare professionals
- practicing exercises regularly
- joining an online or in-person support group to connect with other people who have paralysis
Paraplegia refers to the loss of movement and sensation in both legs and, sometimes, part of the lower abdomen. Quadriplegia affects all four limbs and, sometimes, parts of the chest, abdomen, and back.
Both are forms of paralysis that often result from injury to the spinal cord. The cause may be trauma — sustained during a car accident, for example — or a health problem, such as a stroke.
Paralysis can have lasting, wide ranging effects on a person’s physical health and overall quality of life.
It is not curable, but by using a range of treatments and management strategies, it may be possible for some people to regain partial or complete control over the affected areas.