What Causes Quadriplegia, and Can You Treat It? - GoodRx (2024)

Quadriplegia, or tetraplegia, is weakness of both the arms and legs. This weakness can be so severe that it results in paralysis, or the inability to move any limb. The muscles of the chest, abdomen, back, and pelvis may also be weak. Quadriplegia is often a life-changing condition and may cause significant impairments and disability.

What causes quadriplegia?

Quadriplegia happens when there’s a breakdown in communication from the brain to the muscles of the arms and legs. This commonly occurs with an injury to the brain or spinal cord. But it can also occur with conditions that affect your nerves or muscles.

Common causes of quadriplegia include:

• Spinal cord injury (SCI)

• Traumatic brain injury (TBI)

• Nontraumatic brain damage

• Amyotrophic lateral sclerosis (ALS)

• Guillain-Barré syndrome

• Cerebral palsy

• Muscular dystrophies

Spinal cord injury

This is a common cause of quadriplegia. The brain sends signals for movement and sensation through the spinal cord to the limbs. If the spinal cord is injured, the brain can’t transmit those signals. As a result, the limbs lose strength and feeling.

Car accidents and falls are the most common causes of SCI in the U.S. Other causes include:

• Gunshot wounds

• Physical assaults

• Sports injuries

• Diseases of the spinal cord

Traumatic brain injury

Head trauma can cause damage to the brain. This can change how the brain sends impulses to the rest of the body and may result in quadriplegia. TBI may cause other symptoms, such as problems with thinking, mood, and speech. In some cases, TBI and SCI occur together. And they share some common causes:

• Car accidents

• Falls

• Assaults

• Contact sports

• Gunshot wounds in the head

Nontraumatic brain damage

Infections or a lack of oxygen may damage the brain or cervical spine and cause quadriplegia.

Stroke can also damage the brain or spine. Stroke in the midbrain may cause locked-in syndrome. This is a condition in which a person can think and hear but can’t move or talk. Sometimes they can only communicate through blinking or eye movements.

Amyotrophic lateral sclerosis

ALS is a devastating and life-threatening disease. It causes progressive muscle weakness and problems with speech, swallowing, and breathing.

Guillain-Barré syndrome

Guillain-Barré syndrome can also lead to quadriplegia. In this condition, the immune system attacks the nerves. This causes weakness, numbness, and tingling. In severe cases, the weakness may progress and spread, resulting in quadriplegia.

Cerebral palsy

Children with cerebral palsy have weakness and problems with mobility. It’s due to abnormalities or damage to the brain before, during, or after birth. There are many different types of cerebral palsy. Not all children have the same symptoms or impairments.

Muscular dystrophies

Muscular dystrophies directly affect the muscles, not their communication with the nerves. Weakness is usually progressive but partial. Some muscles may be weak, while others may be stronger. The pattern of weakness depends on the type of muscular dystrophy.

What are the different types of quadriplegia?

The location of the nerve interruption and how much movement you have determine the type of quadriplegia someone has. There are a few types of quadriplegia, including complete/incomplete, spastic, and flaccid.

Complete or incomplete quadriplegia

This classification often refers to paralysis caused by SCIs. Complete quadriplegia involves total paralysis and a loss of sensation below the level of the SCI. With this type of quadriplegia, you can’t move any muscle and don’t have sensation below the neck.

Incomplete quadriplegia is also called “quadriparesis” or “tetraparesis.” This is partial paralysis of the muscles below the neck. You may be able to move some muscles and have some sensation below the level of the injury.

Spastic quadriplegia

With this type of paralysis, the muscles are rigid. Or you may have involuntary contractions, jerks, and spasms. This muscle tightness and stiffness is called “spasticity.” The most severe form of cerebral palsy causes spastic quadriplegia. If you have had a TBI or stroke, you may also have spasticity.

Flaccid quadriplegia

With flaccid quadriplegia, your muscles are limp and have no tone. This loss of muscle tone may occur early after a TBI, SCI, or stroke. This can also occur after infections, as in acute flaccid myelitis.

Symptoms of quadriplegia

The most common symptoms of quadriplegia are muscle weakness and walking difficulties. Other symptoms may vary and depend on the cause and severity of injury. Other symptoms that may occur in quadriplegia include:

• Weakness of both arms and legs

• Loss of feeling (this can be a partial or total loss of sensation in the weak limbs)

• Muscle or nerve pain

• Numbness and tingling

• Breathing difficulties

• Urinary incontinence

• Urinary retention

• Constipation

• Fecal incontinence

Common complications of quadriplegia

The extreme weakness in quadriplegia can lead to complications with other body systems. Common complications with quadriplegia include:

• Pressure ulcers: This is a breakdown of skin and tissue from a lack of mobility for long periods of time. Ulcers may form on the buttocks, hips, heels, elbows, and head.

• Contractures: The muscle fibers can shorten due to immobility and lack of use. This may make a joint stay in a fixed position.

  See Also

  Famous People Who Had or Have Quadriplegia

• Spasticity: Increased muscle tone can be painful and lead to ulcers and contractures. The abnormal stiffness can range from mild to severe muscle spasms.

• Deep vein thrombosis (DVT): DVT is the formation of blood clots in the deep veins. Symptoms may begin in the legs and include calf pain and swelling. But it can travel and lodge in the lungs (pulmonary embolism).

• Osteoporosis: A loss of bone mass can occur due to inactivity. This can greatly increase your risk of fractures.

• Neurogenic bladder: If you have a TBI, SCI, or stroke, you may have trouble controlling your bladder. This can lead to urinary incontinence or retention, urinary tract infection (UTI), kidney stones, or kidney damage.

• Neurogenic bowel: Quadriplegia can cause difficulty with bowel control. This can lead to constipation, fecal retention, or fecal incontinence.

• Autonomic dysreflexia: This is where a common trigger, like a full bladder, causes extreme changes in the cardiovascular and nervous systems. It’s a medical emergency and can cause high blood pressure, headaches, and flushing.

• Respiratory problems: Breathing trouble, coughing, and pneumonia occur often. This is because the lungs do not expand well and can’t clear secretions normally.

• Sexual dysfunction: SCI quadriplegia sometimes affects sexual function and fertility. Vibratory stimulation can help with ejacul*tion to assist in pregnancy. Pregnancy is possible, but there are risks.

• Psychiatric disorders: Anxiety and depression may occur due to involvement of the brain. Disability, pain, and the life changes that come with quadriplegia may also lead to mood changes.

Treatments for people with quadriplegia

There are many supportive treatments for quadriplegia. The treatment often depends on the cause of your quadriplegia and the extent of the injury. We’ll review treatment options here.

Physical therapy

Physical therapy (PT) is important if you have quadriplegia. It strengthens the muscles while not overworking them. Some exercises can help improve your fitness and flexibility. PT can help train you to be as independent as possible. Some goals include managing a wheelchair, transferring to the bed or bath, or using a walker. PT can also help:

• Treat contractures, spasticity, and pain

• Train the respiratory muscles

• Improve mobility

Occupational therapy

Occupational therapy (OT) is necessary to relearn how to do the activities of daily living. Depending on the severity of your weakness, you may need training for activities like eating, bathing, and grooming. The therapist may also prepare splints to help with your positioning and to treat and prevent contractures.

Adaptive devices

If you have quadriplegia, your PT or OT may recommend assistive devices. As technology advances, new devices to help with mobility arrive on the market. These include:

• Sports wheelchairs

• Power wheelchairs

• Electric stimulators (to stimulate the nerves or muscles)

• Assisted walking devices

• Computerized equipment

Psychological therapy

Counseling and emotional support are an important part of the rehabilitation process. This helps improve your mental well-being. It also provides coping strategies as you adjust to challenges you may face.

Recreational therapy

Recreational therapy can be a fun outlet for activity that may help with mood and quality of life. It provides opportunities for you to socialize and engage in adaptive sports. These sports are specialized and competitive activities for people living with disabilities.

Vocational rehabilitation

This type of therapy is useful for those who want to enter the workforce. It can help you figure out the type of work you can do based on your capabilities. Vocational rehab will help you make sure the workplace has the adaptations you need. It may also include transportation accommodations and driving evaluations.

What’s the prognosis like for someone with quadriplegia?

The prognosis for quadriplegia varies based on the cause, type, and severity of the injury. In general, if there are early signs of recovery, you’re more likely to see continued improvement. But the recovery process takes time and patience. In fact, less than 1% of people with SCI have completely recovered at the time of hospital discharge.

If you have paralysis from a SCI you may recover some mobility. If you have an incomplete SCI, you have a better chance of walking 1 year after the injury.

If your injury is at a higher level in the neck, you may need help with eating, dressing, toileting, and rolling in bed. If your injury is in the lower neck, you may have enough movement to operate a wheelchair or walk short distances.

Overall life expectancy is shortened with quadriplegia. This is often due to serious complications, like infections, blood clots, and pneumonia.

The prognosis after a TBI may be better. People who are younger and with less severe injuries are more likely to walk again. In fact, many people with severe injuries are able to walk within a few months. The prognosis for progressive diseases is less promising.

How can you make living with quadriplegia easier?

There are several adjustments that can make living with quadriplegia easier. In most cases, there will be a period where you and your caregivers have to adjust to the circ*mstances. Support from friends and family can make this period more bearable.

If you or a loved one has quadriplegia, other tips for easier living may include:

• Frequent position changes: A position bed with a gel or air mattress may help avoid ulcers. Lifting equipment may help reduce neck and back injuries in caregivers.

• Home modifications: You can help prevent falls by making your home wheelchair accessible and placing grab bars in the hallways and bathroom. Putting objects in reach will help you become more independent.

• Easy transport: Ramps and modified cars to accommodate wheelchairs may be useful. This is especially true when you have to go out for medical appointments or recreation.

• Comfort: A comfortable wheelchair with adequate cushioning and positioning can make a big difference.

• Rehabilitation services: Look for resources available in the community. Rehab teaches people with quadriplegia — and their caregivers — how to cope with limitations.