What Everyone Should Know about Quadriplegia/Tetraplegia

Quadriplegia, also known as tetraplegia, is a life-altering condition that results in a loss of control of both arms and both legs.

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Quadriplegia Risk Factors

Knowing the causes of quadriplegia is important. However, what are some of the risk factors that can contribute to someone becoming quadriplegic? First, what is a quadriplegia risk factor?

It is important to note that a risk factor is different from a cause in that it may not directly contribute to the development of a given condition. A risk factor may simply make it possible or easier for a condition (like quadriplegia) to develop or create circumstances that allow someone to suffer a quadriplegia-causing injury.

To highlight the difference between a cause and a risk factor, consider someone falling off a tall ladder. On impact, the faller breaks their cervical spine and loses feeling in their arms and legs—becoming quadriplegic. In this instance, the fall was the cause of the quadriplegia, but being on a tall ladder was the risk factor that most contributed to the fall.

Some risk factors that may contribute to the occurrence of SCIs and TBIs leading to the development of quadriplegia include:

  • Gender. Males are more likely to suffer an SCI than females. In fact, the 2019 NSCISC report showed that while 27,453 men suffered SCIs from various causes, only 6,672 women suffered SCIs in the same time period. So, being male may be a risk factor for quadriplegia-causing injuries.
  • Age. The specific age at which risk for an SCI or TBI is greatest has shifted over the years. According to NSCISC, in the late 70s, the mean “age at injury” (how old the SCI survivor was at the time of their injury) was roughly 28 years old. In the 2015-2019 period, the mean age at injury had increased to around 43 years old. Also, as people age, they become more susceptible to severe SCIs and TBIs—especially if they suffer from osteoporosis or other conditions that impact bone health.
  • Risky Behaviors. Doing things like diving, driving dangerously (or without wearing seatbelts), or playing high-contact sports can all contribute to the risk of suffering a spinal cord or brain injury that leads to full-body paralysis.
  • Career Choice. Certain careers, such as police officers, construction workers, and professional athletes in high-contact sports all face increased risk of injury from violence or accidents on the job. This, in turn, puts them at higher-than-average risk of becoming a quadriplegic.
  • Family Health History. If a condition like ALS (a.k.a. Lou Gehrig’s Disease) runs in your family, there is a risk of developing it and losing control of your arms and legs.

Quadriplegia Prevention

By knowing the major risk factors for quadriplegia, a certain amount of quadriplegia prevention is possible. However, it is important to note that not all risks can be avoided perfectly. It is possible for anyone to have a slip and fall, inherit a congenital disease, or be subjected to a random act of violence that leads to quadriplegia.

Some basic steps for minimizing quadriplegia risk factors include:

  • Getting Tested for Congenital Diseases. It is important to discuss your family health history with your doctor and receive screening for various conditions that may run in your family. Catching the warning signs of ALS or other conditions early on can make a major difference in your therapy.
  • Wearing Appropriate Safety Equipment. In sports, on motorcycles, or at high-risk work sites, it is important to wear the appropriate safety gear whenever possible. A hard hat/helmet could mean the difference between severe open-head wounds and a concussion (though a concussion is still serious and should be checked by a doctor)!
  • Avoiding Risky Behaviors. Avoiding behaviors like drinking and driving, diving (especially in shallow waters), and other activities that can lead to serious bodily harm should be avoided. When risky situations can not be avoided, appropriate safety gear should be used whenever possible.
  • Maintaining a Healthy Diet and Exercise Regimen. Bone and muscle health can have a major impact on the severity of certain injuries. An impact that would merely cause pain to someone with a healthy musculoskeletal system may shatter bones in someone with bone and joint disorders. A diet and exercise regimen can help promote bone health—though it may not prevent disorders such as osteoporosis that negatively impact bone strength.

Types of Quadriplegia

Many people think that all quadriplegics are the same—that none of them are able to move their arms and legs at all. However, there are several types of quadriplegia—including incomplete, complete, and spastic quadriplegia that have some key differences.

Incomplete Quadriplegia

An “incomplete quadriplegic” is different from a complete paraplegic in that they may still retain some function and/or sensation in their arms or legs. This may be the case with incomplete or "partial" SCI, some TBIs, and some inherited conditions that cause quadriplegia.

Depending on the cause, some people with incomplete quadriplegia may see improvement in their ability to control their limbs with certain quadriplegia therapies and exercises. However, others may see their incomplete quadriplegia progress into complete quadriplegia as their condition progresses.

Complete Quadriplegia

Complete quadriplegia is characterized by a complete loss of control over the arms and legs. This is a near-total form of paralysis where a person is wholly unable to move their extremities aside from their head.

When comparing complete vs incomplete quadriplegia, the complete version of the condition is usually considered more severe. Complete quadriplegia is often caused by severe, complete SCI in the cervical vertebrae or traumatic injuries to the brain.

Recovery and exercise will be more difficult for a complete quadriplegic than an incomplete quadriplegic, though there are still quadriplegia therapy options!

Spastic Quadriplegia

Spasticity (or spastic hypertonia) is a common side effect of spinal cord and brain injuries caused by trauma or disease. A spastic quadriplegic is someone who, though they can not consciously control their arms or legs, may experience muscle spasms in their paralyzed limbs.

Quadriplegics experiencing spastic hypertonia may experience hyperactive reflexes or involuntary muscle tightness that makes it hard to move into a relaxed posture.

Spasticity may be caused by cysts in the spinal cord that formed after an SCI, infections of the nervous system, or other blockages—which is why it is important to have a qualified doctor diagnose the cause of the quadriplegia and recommend an appropriate therapy regimen.

Diagnosing Quadriplegia

Doctors-Looking-At-Results-ImageMany people wonder about “how to diagnose quadriplegia.” While some may assume that it is easy to tell if you have developed quadriplegia because of the loss of limb function, with some conditions that lead to quadriplegia, it is not that clear-cut. Being able to diagnose it early can help expand your therapy options and improve your overall prognosis by treating contributing factors early.

Doctors may use several methods to diagnose different causes of quadriplegia, such as:

  • MRI Scans. Doctors can use MRI scans to check for abnormalities such as brain tumors, cysts, and herniated disks in the spinal cord that may be impeding signals from the brain.
  • Spinal Taps (Lumbar Punctures). Doctors may need to draw some cerebrospinal fluid from the spinal column to analyze it and check your spinal health.
  • Blood Tests. To check for deficiencies or to check for genetic markers that could indicate that a congenital condition that causes paralysis was inherited.
  • Electromyography (EMG) Tests. Doctors may test nerve function to help differentiate between muscle and nerve disorders.