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Changes: Paraplegia

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'''Paraplegia''' is an impairment in motor and/or sensory function of the lower extremities. It is usually the result of [[spinal cord injury]] or a [[congenital]] condition such as [[spina bifida]] which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis, [[tetraplegia]] is the proper terminology.
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'''Paraplegia''' is a [[paralysis]], an impairment in motor and/or sensory function of the lower extremities. It is a [[central nervous system disorder]] and is usually the result of [[spinal cord injury]] or a [[congenital]] condition such as [[spina bifida]] which affects the neural elements of the [[spinal canal]]. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis, [[tetraplegia]] is the proper terminology.
   
 
== Causes ==
  
== Causes ==
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The causes range from trauma (acute spinal cord injury: transsection or compression of the cord, usually by bone fragments from vertebral fractures) to tumors (chronic compression of the cord), myelitis transversa and multiple sclerosis.
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The causes range from trauma (acute spinal cord injury: transsection or compression of the cord, usually by bone fragments from vertebral fractures) to tumors (chronic compression of the cord), myelitis transversa and [[multiple sclerosis]].
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===Central nervous system===
  
===Central nervous system===
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Any disease process affecting the [[pyramidal tract]] of the spinal cord from the [[thoracic spine]] downward may lead to paraplegia, as this structure transmits "instructions" for movement from the [[brain]] to the [[anterior horn]]. This is the most common cause of paraplegia. It is usually [[spasticity|spastic]]: it results in an increased [[muscle tone]] in the affected limbs. Causes range from [[Physical trauma|trauma]] (acute [[spinal cord injury]]: transsection or compression of the cord, usually by bone fragments from [[vertebra]]l fractures) to [[tumor]]s (chronic compression of the cord), [[myelitis transversa]] and [[multiple sclerosis]]. Gunshot wounds to the spine are one of the major causes of paraplegic spinal cord injuries (for instance, Ron Kovic, author of ''Born on the Fourth of July'', is a paraplegic as a result of a gunshot wound suffered in the [[Vietnam War]]). Sometimes, [[paralysis]] of both legs can result from injury to the brain (bilateral injury of the [[motor cortex]] controlling the legs, e.g. due to a [[stroke]] or a [[brain tumor]]).
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Any disease process affecting the [[pyramidal tract]] of the [[spinal cord]] from the [[thoracic spine]] downward may lead to paraplegia, as this structure transmits "instructions" for movement from the [[brain]] to the [[anterior horn]]. This is the most common cause of paraplegia. It is usually [[spasticity|spastic]]: it results in an increased [[muscle tone]] in the affected limbs. Causes range from [[Physical trauma|trauma]] (acute [[spinal cord injury]]: transsection or compression of the cord, usually by bone fragments from [[vertebra]]l fractures) to [[tumor]]s (chronic compression of the cord), [[myelitis transversa]] and [[multiple sclerosis]]. Gunshot wounds to the spine are one of the major causes of paraplegic spinal cord injuries. Sometimes, [[paralysis]] of both legs can result from injury to the brain (bilateral injury of the [[motor cortex]] controlling the legs, e.g. due to a [[stroke]] or a [[brain tumor]]).
   
 
===Peripheral nervous system===
  
===Peripheral nervous system===
 
Rarer is the type which is caused by damage to the [[nerve]]s 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.
  
Rarer is the type which is caused by damage to the [[nerve]]s 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.
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==Genetic causes==
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*[[Hereditary spastic paraplegia]]
   
 
== Disability ==
  
== Disability ==
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== See also ==
  
== See also ==
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*[[Quadriplegia]]
  
 
*[[Cauda equina syndrome]]
  
*[[Cauda equina syndrome]]
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*[[Hemiplegia]]
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*[[Injuries]]
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*[[Musculoskeletal disorders]]
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*[[Palmoplantar keratoderma and spastic paraplegia]]
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*[[Quadriplegia]]
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*[[Spastic diplegia]]
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*[[Spastic paraplegia]]
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*[[Spastic quadriplegia]]
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*[[Spinal cord injuries]]
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{{Cerebral palsy and other paralytic syndromes}}
  
{{Cerebral palsy and other paralytic syndromes}}
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[[Category:Neurotrauma]]
  
⚫
[[Category:Injuries]]
  
 
[[Category:Disability]]
  
[[Category:Disability]]
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[[Category:Paraplegics]]
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[[Category:Injuries]]
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[[Category:Neurotrauma]]
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[[Category:Paralysis]]
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[[Category:Paraplegia]]
   
 
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Paraplegia
ICD-10
ICD-9
OMIM [1]
DiseasesDB [2]
MedlinePlus [3]
eMedicine /
MeSH {{{MeshNumber}}}

Paraplegia is a paralysis, an impairment in motor and/or sensory function of the lower extremities. It is a central nervous system disorder and is usually the result of spinal cord injury or a congenital condition such as spina bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis, tetraplegia is the proper terminology.

Causes

The causes range from trauma (acute spinal cord injury: transsection or compression of the cord, usually by bone fragments from vertebral fractures) to tumors (chronic compression of the cord), myelitis transversa and multiple sclerosis.

Central nervous system

Any disease process affecting the pyramidal tract of the spinal cord from the thoracic spine downward may lead to paraplegia, as this structure transmits "instructions" for movement from the brain to the anterior horn. This is the most common cause of paraplegia. It is usually spastic: it results in an increased muscle tone in the affected limbs. Causes range from trauma (acute spinal cord injury: transsection or compression of the cord, usually by bone fragments from vertebral fractures) to tumors (chronic compression of the cord), myelitis transversa and multiple sclerosis. Gunshot wounds to the spine are one of the major causes of paraplegic spinal cord injuries. Sometimes, paralysis of both legs can result from injury to the brain (bilateral injury of the motor cortex controlling the legs, e.g. due to a stroke or a brain tumor).

Peripheral nervous system

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.

Genetic causes

Disability

While some people with paraplegia can walk to a degree, many are dependent on wheelchairs or other supportive measures. Impotence and various degrees of urinary and fecal incontinence are very common in those affected. Many use catheters and/or a bowel management program (often involving suppositories, enemas, or digital stimulation of the bowels) to address these problems. With successful bladder and bowel management, paraplegics can virtually prevent all accidental urinary or bowel discharges; it is however another option for the patient to wear undergarments such as diapers to further protect from bladder or fecal incontinence. Some prefer diapers for the comfort level they provide.

Complications

Due to decreased movement and loss of the ability to run, paraplegia may cause numerous medical complications, many of which can be prevented with vigilant self care. These include pressure sores (decubitus), thrombosis and pneumonia. Physiotherapy and various assistive technology, such as a standing frame, may aid in preventing these complications.

Support organizations

See also


v·d·e
Cerebral palsy and other paralytic syndromes (G80-G83, 342-344)
Paresis and plegia NOS

Paralysis - Quadriplegia - Triplegia - Hemiplegia/Hemiparesis - Paraplegia/Diplegia - Monoplegia

Flaccid vs. spastic

Flaccid paralysis - Spastic diplegia - Spastic paraplegia

Specific types

Cerebral palsy - Cauda equina syndrome - Locked-In syndrome

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