Paraplegia
Encyclopedia
Paraplegia is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek
Ionic Greek
Ionic Greek was a subdialect of the Attic–Ionic dialect group of Ancient Greek .-History:Ionic dialect appears to have spread originally from the Greek mainland across the Aegean at the time of the Dorian invasions, around the 11th Century B.C.By the end of the Greek Dark Ages in the 5th Century...

: παραπληγίη "half-striking". It is usually the result of spinal cord injury
Spinal cord injury
A spinal cord injury refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence...

 or a congenital condition such as spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...

 that affects the neural elements of the spinal canal. The area of the spinal canal that is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If both arms are also affected by paralysis, quadriplegia
Quadriplegia
Tetraplegia, also known as quadriplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms...

 is the proper terminology. If only one limb is affected, the correct term is monoplegia
Monoplegia
In medicine, monoplegia is a paralysis of a single limb, usually an arm. It is frequently associated with cerebral palsy. This is the mildest form of cerebral palsy, and individuals with it generally have a good prognosis for later life. It can also be used if just one muscle group or muscle is...

.

Spastic paraplegia is a form of paraplegia defined by spasticity
Spasticity
Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles...

 of the affected muscles, rather than flaccid paralysis
Flaccid paralysis
Flaccid paralysis is a clinical manifestation characterized by weakness or paralysis and reduced muscle tone without other obvious cause .-Polio:...

.

Disability

While some people with paraplegia can walk
Walking
Walking is one of the main gaits of locomotion among legged animals, and is typically slower than running and other gaits. Walking is defined by an 'inverted pendulum' gait in which the body vaults over the stiff limb or limbs with each step...

 to a degree but it may not be good for the hip, many are dependent on wheelchair
Wheelchair
A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...

s or other supportive measures. Depending on the level and extent of spinal damage, people with paraplegia may experience some, or complete loss of sensation in the affected limbs. Impotence and various degrees of urinary
Urinary incontinence
Urinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...

 and fecal incontinence
Fecal incontinence
Fecal incontinence is the loss of regular control of the bowels. Involuntary excretion and leaking are common occurrences for those affected. Subjects relating to defecation are often socially unacceptable, thus those affected may be beset by feelings of shame and humiliation...

 may also occur. Many use catheters or a bowel management program (often involving suppositories
Suppository
A suppository is a drug delivery system that is inserted into the rectum , vagina or urethra , where it dissolves.They are used to deliver both systemically-acting and locally-acting medications....

, enemas, or digital stimulation of the bowels) to address these problems. With successful bladder and bowel management, paraplegics can prevent virtually all accidental urinary or bowel discharges.. Some paraplegics prefer the use of incontinence products, such as Depend
Depend
Depend is a brand of unisex adult underwear for those experiencing urinary or fecal incontinence by Kimberly-Clark. They were first introduced in 1984....

, as an alternative.

Complications

Due to the decrease or loss of feeling or function in the lower extremities, paraplegia can contribute to a number of medical complications including pressure sores (decubitus), thrombosis
Thrombosis
Thrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss...

, and pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...

. Physiotherapy and various assistive technology
Assistive technology
Assistive technology or adaptive technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them...

, such as a standing frame
Standing frame
A standing frame is assistive technology that can be used by a person who relies on a wheelchair for mobility...

, as well as vigilant self-observation and -care, may aid in helping to prevent future complications and mitigate existing complications.

As paraplegia is most often the result of a traumatic injury to the spinal cord tissue and the resulting inflammation, other nerve-related complications can and do occur. Cases of chronic nerve pain in the areas surrounding the point of injury are not uncommon. There is speculation that the "phantom pains" experienced by individuals suffering from paralysis could be a direct result of these collateral nerve injuries misinterpreted by the brain.

See also

  • Hemiplegia
    Hemiplegia
    Hemiplegia /he.mə.pliː.dʒiə/ is total paralysis of the arm, leg, and trunk on the same side of the body. Hemiplegia is more severe than hemiparesis, wherein one half of the body has less marked weakness....

  • Quadriplegia
    Quadriplegia
    Tetraplegia, also known as quadriplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms...

  • Cauda equina syndrome
    Cauda equina syndrome
    Cauda equina syndrome ' is a serious neurologic condition in which there is acute loss of function of the lumbar plexus, neurologic elements of the spinal canal below the termination of the spinal cord.-Causes:...

  • The Body Silent
    The Body Silent
    The Body Silent is a personal narrative written by Robert Murphy, a professor at Columbia University. This piece is a narrative of personal struggle through a spinal condition, published in 1987 by Henry Holt and Company, Inc. He uses this narrative to tell his journey through a deteriorating...


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