Quadriplegia

Quadriplegia

1. TOPIC QUADRIPLEGIA

2. Quadriplegia is caused by damage to the  brain  or the  spinal cord  at a high level at lower Medulla, at level of crossing over of motor fibres , or direct injury at C1-C5 levels Pathophysiologically Direct spinal cord injury eg Traumatic spinal cord injury a) Complete spinal cord lesion b) Incomplete spinal cord lesion 2)Posterior circulation infract extending into high up spinal cord 3)Infective processes affecting cords in high up cirvival levels eg Potts spine 4)Neoplastic destruction of cervical cord at high level C1-C5 5)Ant spinal artery infraction at higer level C1-C5

3. Spinal cord injuries  are classified as complete and incomplete by the  American Spinal Injury Association  (ASIA ) American Spinal Injury Association Impairment Scale [2] A Complete No motor or sensory function is preserved in the sacral segments S4–S5. B Incomplete Sensory function preserved but no motor function is preserved below the neurological level and includes the sacral segments S4–S5. C Incomplete Motor function is preserved below the neurological level; more than half of key muscles below the neurological level have a muscle grade less than 3. D Incomplete Motor function is preserved below the neurological level; at least half of key muscles below the neurological level have a muscle grade of 3 or more.

4. Management Immobalisation by cervical support/ rigid neck collor as soon as signs of quadriplegia are recognised to prevent lethal brain stem injury that can cause immediate death Imaging modality like MRI brain and Cervical cord. CT/MR angiography may be indicated if initial scans fails to clinch diagnosis Steroids coverage , in initial state reduce local inflammation , swelling and compression feature, helpful Patient evaluated for Surgical intervention as requried to rapidly decompress spinal cord and to remove external objects / bone fragments Long term rehablitation and physiotherapy is indicated in such patients

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