Quadriplegia is a form of paralysis that affects all four limbs and the torso, caused by damage to the spinal cord or brain. It can be complete or incomplete. Complete quadriplegia results in total paralysis of the arms and legs while incomplete allows some movement or sensation. Spastic quadriplegia involves muscle spasms. Damage levels also impact symptoms, with higher damage carrying worse prognoses like loss of breathing control. Common causes are vehicle accidents, falls, and injuries. Treatment involves immobilization, imaging, steroids, surgery if needed, and long-term rehabilitation.

2. Quadriplegia, also known as tetraplegia, is a
form of paralysis that affects all four limbs,
plus the torso (“quad” originates from the Latin
word for four). Most people with tetraplegia
have significant paralysis below the neck, and
many are completely unable to move.
Quadriplegia is caused by damage to the
brain or the spinal cord at a high level at
lower medulla, at level of crossing over
motor fibres or direct injury at cervical spine
levels.

3.  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.
 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.
 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.

4.  C1, C2, C3 Damage
• Damage to the spinal column at the vertebrae nearest the skull (the C1, C2, and C3
vertebrae) is more likely to be fatal than damage lower on the spinal column. C1 and C2
injuries are considered particularly severe, as they are frequently fatal and may impede
respiratory function.
• In the case of a complete SCI, damage at this level is extremely likely to result in near-total
paralysis and may require specialized devices to allow the injured person to breathe.
 C4 Damage
SCI survivors with damage to the C4vertebramay experience:
• Loss of diaphragm control (requiring breathing aids such as a ventilator)
• Limited range of motion or paralysis of the arms, torso, and legs
• Trouble with bowel and bladder control

5.  C5 Damage
• Damage to the C5 vertebra may affect the vocal cords and result in paralysis to the legs,
wrists, and hands.
• While a person with a C5 spinal injury may have difficulty talking, they may still be able to
breathe unassisted.
 C6 Damage
Damage to the C6 spinal cord and below is less likely to
cause complete loss of the function of the arms. A person with
a C6 injury may:
• Be paralyzed in the legs, torso, and hands
• Be unable to control their bladder/bowel
• Have difficulty speaking normally

6. There are numerous potential causes of
quadriplegia.As mentioned earlier most common
known cause of quadriplegiais damage to the spinal
cord—typically in the cervical vertebrae (the C1-C7
sections of the spine which are nearest to the skull).
•Auto Accidents (32.2%)
•Falls (22.9%)
•Gunshot Wounds (15.2%)
•Motorcycle Accidents (6.2%)
•Diving (5.7%)
•Medical/Surgical Complications (2.9%)
•Being Hit by a Flying/Falling Object
(2.7%)
•Bicycle Accidents (1.7%)
•Pedestrian Accidents (1.5%)

7. MECHANISM OF INJURY
 Destruction of cord parenchyma from direct trauma.
 Compression by bone fragments, heamatoma or disc material.
 Ishchaemia from damage or impingement on spinal arteries.

8. • Loss of movement
• Loss of sensation
• Loss of bowel and bladder control
• Exaggerated reflex activities or spasms
• Changes in sexual function, sexual
sensitivity & fertility
• Pain and tingling
• Difficulty in breathing , coughing or
clearing secretions from your lungs.

9. MRI Scans
Spinal taps (Lumbar punctures)
Blood tests
Electomyography (EMG) Tests

10. Acute onset quadriplegia Complete quadriplegia Traumatic quadriplegia

11. • Immobilization by cervical support/ rigid neck collar as soon as signs
of quadriplegia are recognized to prevent 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 .
• Patient evaluated for Surgical intervention as required to rapidly
decompress spinal cord and to remove external objects / bone
fragments.
• Long term rehabilitation and physiotherapy is indicated in such
patients.

12. For Your Attention