Dr Ira Shah
Consultant Pediatrician, Nanavati Hospital and B.J.Wadia Hospital for Children, Mumbai
Editor - Pediatric Oncall
What is paraplegia?
Paraplegia is a condition in which a person develops weakness of both legs due to problems either in the spinal cord or the nerves supplying the muscles of lower limbs or due to involvement of the muscles directly. The person loses his/her ability to walk, stand or sit and may be completely paralyzed in both lower limbs. Sometimes, the patient also loses control of the urinary bladder and bowel movements as a result of which, there may be inability to pass urine or stool. There may be also loss of temperature and pain sensations in affected areas of the body. Paraplegia means complete paralysis whereas paraparesis means partial weakness in both lower limbs.
What are the causes of paraplegia?
Paraplegia can be due to a variety of causes. Sudden onset paraplegia are often due to infections such as transverse myelitis, trauma to the spinal cord, fracture of spinal vertebrae or any clot in the blood vessel supplying the spinal cord. Sometimes paraplegia may evolve over a period of time as with TB (tuberculosis), Guillian barre syndrome (GBS) poliomyelitis, tumors or demyelination. Occasionally children with spastic cerebral palsy may have paraplegia. Rarely paraplegia can occur due to genetic diseases such as spinocerebellar hereditary spastic paraplegia.
How is the diagnosis of paraplegia made?
The diagnosis of paraplegia is made clinically by your doctor. Depending on the cause suspected, your doctor may order certain investigations such as MRI of the spine, nerve conduction velocity studies (NCV) and electromyography (EMG).
What is the treatment of paraplegia?
Patients with paraplegia need to undergo physiotherapy to improve the power in the affected muscles. If they have inability to pass urine or stool then catheter may have to be put into the urinary bladder to decompress the bladder and enemas may required if there is constipation. The patient may require aids such as wheel chairs and walking sticks to enable increased mobility. Depending on the cause of paraplegia, medicines may be prescribed for e.g. anti TB medications may be started in case of TB spine. In GBS and transverse myelitis, intravenous immunoglobulin (IVIG) may be given. In case of demyelinating disorders, steroids may be given. For trauma or fracture, bracing and surgery to decompress the spinal cord may be required.
Will the patient with paraplegia have complete recovery?
Recovery will depend on the extent of damage to the spinal cord, the physiotherapy that a patient undergoes and the cause of paraplegia. Patients with transverse myelitis, GBS and demyelination have good recovery usually.
What is quadriplegia?
Quadriplegia is paralysis of both upper limbs and both lower limbs. This is due to affection of the cervical spine or due to GBS. Treatment is same as that of paraplegia.
Last updated on 26-12-2010