You may have heard the word ‘paralysis’ thrown around when someone refers to a condition where an individual experiences a loss of movement. But, did you know that there are different types of paralysis? Paraplegia is one of the most common types of paralysis and this is the place for you to learn about it more.
Paraplegia is a type of paralysis that affects only the lower half of the body. This includes loss of movements and sensations on both legs. Paraplegia is mostly caused by injuries to the spinal cord and is considered a medical emergency. However, it is more complex than that. This article will be exploring the causes, symptoms, management, diagnosis and risk factors of paraplegia.
Paraplegia is a type of paralysis that only affects the lower extremities e.g. legs. It is commonly caused by trauma to the spinal cord such from a car accident or a stab wound for example. These can result in either complete paraplegia (complete loss of movement and sensation) or incomplete paraplegia (enabling restricted movement and sensations)
Although there is currently no cure for paraplegia,there are multiple ways to manage it.
Causes of paraplegia
Paraplegia is caused by damage to the spinal cord, which prevents the nervous system from communicating with the lower body. This is commonly due to high impact injuries such as car accidents, sport injuries, physical altercations, falls or suicidal attempt.
When parts of the nervous system such as spinal cord or brain are damaged, it will likely lead to a loss of signalling to the nerves below the site of injury. However, such damages can also be caused by other medical conditions such as cancer, multiple sclerosis, stroke, cerebral palsy and tumors in the nervous system.
Paraplegia can also stem from a rare genetic defect causing weakeness and stiffeness of the legs. This is known as‘Hereditary Spastic Paraplegia’ (HSP)..
Signs and symptoms of paraplegia
Symptoms of paraplegia vary from person to person depending on the severity of the injury and individual health conditions. The immediate symptoms are the loss of both sensation and movement to both legs. This can be a gradual decline or complete loss of control. Phantom pain or neuropathic pain on the lower half of the body, loss of bladder and bowel control, and chronic pain in legs, trunks, and pelvic region.
Sexual and fertility difficulties, as well as depression and weight gain often accompany paraplegia and worsen overtime.
Management and treatment for paraplegia
There is currently no cure for paraplegia. Although, the loss of movement and sensations worsen overtime, there are ways for patients to manage their symptoms and slow disease progression. However, the imapct of disease management varies among individuals. Treatment and management should be conducted as soon as possible after the injury for the best chance at recovery.
The most common treatment for paraplegia caused by injury is surgery. The aim of the surgery is toreduce swelling at the injury site and/or toalign the spinal cord or remove tumors, lesions or other objects. Anti-inflammation and blood clot medications are commonly prescribed as an initial treatment. Physical therapy and exercise are highly encouraged as it can slow mobility decline in paraplegics and improve other complications such as chronic pain and blood circulation issues.
Mental health should also be considered when designing treatment and management plans for people with paraplegia. Psychotherapy can help paraplegics cope with their life-style changes and cope with these.
Diagnosis of paraplegia
In-depth examinations are commonly performed when a person experiences paraplegia. This includes medical imaging i.e. MRIs, CT scans and x-rays. Neurological examinations are performed to check for neurological abnormalities relating to the loss of signaling in the lower extremities. Electromyography can also be used to check the muscles' responsiveness.
In case of a gradual loss of mobility in the lower body or non-trauma causing paraplegia, family history may be checked as some genetic defects can contribute or paraplegia.
Risk factors for paraplegia include participating in high impact sports. This includes but is not limited to rugby, wrestling or gymnastics, and individuals with a history of cancer, tumors or lesions.
How can I prevent paraplegia?
Although certain causes of paraplegia can be more unpredictable, there are ways to reduce the risk of developing paraplegia caused by trauma or injury.
The most effective way to prevent paraplegia is to avoid high impact injuries. This can be done by wearing safety equipment such as seatbelt while in a vehicle, taking extra precautions using firearms, wearing non-slip footwear, and avoiding misusing medication, drugs or alcohol that reduce individuals consciousness.
How common is paraplegia?
The prevalence of complete paraplegia is estimated to be around 5 per 1000 among individuals with traumatic spinal cord injury.1 Considering that there are 250,000 - 500,000 new cases of spinal cord injury annually, paraplegia due to trauma is not a rare condition.
On the other hand, the occurence of paraplegia due to genetic defects such as HSPs depends on its subtype can range from 1 to 10 per 1,000,000 individuals worldwide, making it extremely rare.
What can I expect if I have paraplegia?
Paraplegia is a life-altering condition with various complications. The most common complications are localized within the pelvic region. This includes the loss of bowels and bladder controls, higher risk of urinary tract infections (UTI), chronic pain i.e. sores, and decreased sexual arousal due to a loss of sensation in the pelvic region.
Another common complication is circulatory disorders. This is due to the inability to move freely causing decreased blood circulation around the body. Therefore, participating in exercise or physiotherapy can relieve and reduce the risk of worsening circulatory functions.
It is common for paraplegic individuals to experience difficulties in adjusting to a new life-style. Many can develop chronic depression post paraplegic-causing injury. Therefore, it is extremely important for paraplegics to have a support system and develop coping mechanisms.
When should I see a doctor?
Paraplegia is a medical emergency and should seek medical attention as soon as the injury occurs.
Paraplegia is a condition where an individual experiences loss of movement and sensation in both legs. This is commonly caused by a high impact injury that damages the nerve in the spinal cord. There is currently no cure however, surgery can be used to improve the conditions along with physical therapy. Paraplegia is a medical emergency and should seek medical attention immediately for a better chance of recovery.
- Kurtzke JF. Epidemiology of Spinal Cord Injury. Experimental Neurology. 1975;48(3):163–236