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Paraplegia

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Paraplegia is a condition where the lower half of a patient's body is paralyzed and cannot move. It is usually the result of spinal cord injury or a congenital condition such as spina bifida, but polyneuropathy may also result in paraplegia. If the arms are also paralysed, quadriplegia is a more appropriate diagnosis.

Contents

Causes

Any disease process affecting the pyramidal tract of the spinal cord from the thoracic spine downward may lead to paraplegia, as this structure transmits "intructions" for movement from the brain to the anterior horn. These forms of paraplegia are usually spastic: they result in an increased tone in the affected limbs. Causes range from trauma (transsection of the cord) to myelitis transversa and multiple sclerosis.

Rarer is the type which is caused by damage to the nerves supplying the legs. This form of damage is not usually symmetrical and would not cause paraplegia, but polyneuropathy may cause paraplegia if motor fibres are affected. While in theory the arms should also be affected, the fibres that supply the legs are longer and hence more vulnerable to damage.

Disability

While some people with paraplegia can walk to a degree, many are dependant on wheelchairs or other supportive measures. Impotence and various degrees of urinary and fecal incontinence are very common in those affected.

Complications

Due to the decreased movement and inability to walk, paraplegia may cause numerous medical complications, many of which can be prevented with good nursing care. This includes pressure sores (decubitus), thrombosis and pneumonia. Physiotherapy, apart from in assisting in movement, may aid in preventing these complications.

Support organisations

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