Paraplegia is damage to the nerves in the back. As a result, a person becomes fully or partially paralyzed from the site of the damage. In case of a full paraplegia, the nerves in the spinal cord are completely damaged and cannot be cured. In case of a partial paraplegia, the spinal cord is partly damaged and some recovery is possible.
Cause
Paraplegia is often caused by an accident. Traffic accidents, sports accidents or wrong landing after a fall can cause the spine to break or crush. Then, pieces of the spine may touch the spinal cord and pinch or damage the nerves. Due to this damage, the nerves can no longer pass their impulses downwards through the spine.
Other causes of paraplegia are:
- Gunshot and stab wounds.
- Damage during surgery.
- Inflammations.
- Tumors.
- Bleeding.
- Infarctions.
- Disease of the spine or in the spinal cord, for example multiple sclerosis or a herniation.
Symptoms
The signs and symptoms of paraplegia depend on the place where the damage in the spinal cord is located and whether it’s a full or partial paraplegia. The higher the paraplegia is located, the more failures the patient has. Severe physical disabilities have to be taken into account. The patient loses control over a part of his body, becomes paralyzed and can lose feeling in certain parts of the body.
Furthermore, the patient can lose control of bladder and bowel muscles, causing incontinence. One can also suffer from urinary tract infections, pain, spasms and bedsores. Additionally, men may suffer from erectile dysfunction, because the nerve connection between brains and penis is broken.
Diagnosis
Paraplegia is initially determined on the basis of physical examination in combination with the medical history of the patient. In case of suspected paraplegia, the patient will immediately be referred to a neurologist, who can make the diagnosis by means of X-ray, CT scan and/or MRI scan.
Treatment
The patient must learn to move in a different way, for example with the aid of a wheelchair. Furthermore, one is probably a lot more dependent on resources and other people. By means of intensive rehabilitation (both physical and mental) and physical therapy, the muscles will strengthen and the patient will learn how to use his or her body best.
Prognosis
Paraplegia is not curable. If nerves are damaged, they cannot be restored. Nerves cannot repair themselves, like for example the skin can. Very rarely, part of the lost functions return, but the residual function loss is permanent. It will be difficult to accept that.
Considerations
- It is normal that a person feels depressed after the accident or disease which caused the paralysis. The patient has lost the normal functioning of (a part of) the body, which he or she took for granted until now. Feelings of anger, sadness, fear and frustration, but also denial are normal responses that the patient can experience. It takes time to recover emotionally.
- Partner, family and friends also need to get used to the new situation. They need to adapt and get used to the changes. They have their own grief, anger or frustration. It’s important to discuss this with each other.
