Symptoms of paraplegia

Synonyms in a broader sense

Symptoms of paraplegia, paraplegia, paraplegia, transverse syndrome

Medical: Paraplegia, (spinales)

English: paraplegia, transverse lesion

Symptoms

The symptoms that occur in the context of paraplegia are primarily dependent on the extent of the damage. The spinal cord is divided into segments, each of which is responsible for supplying certain muscles, organs and skin areas. Those segments that are above the injury can continue to work normally. If the arms and legs are affected by paraplegia, it is called tetraplegia, but if only the legs are affected, it is called paraplegia.

Symptoms of the onset of paraplegia

The beginning of complete paraplegia manifests itself in a so-called spinal shock.

Spinal shock is an acute situation that occurs immediately after the event that caused the paraplegia. This could be a household accident, for example. In some cases, damage in this phase is still reversible if it is not too pronounced. This means that some symptoms may improve a little after a week.

However, this varies greatly from person to person and depends on the extent of the damage. Below the damage, there is a disturbance of sensitivity. These sensory disturbances include both feeling sensitive on the skin and feeling pain or temperature.

Furthermore, there are motor failures that result in a Paraplegia or quadriplegia express. The term Paraplegia denotes complete paralysis of both legs, whereas one quadriplegia in addition, the arms are paralyzed.

In the spinal shock phase, all reflexes fail and can no longer be triggered in the neurological examination. This changes in the advanced stage of paraplegia, which is characterized by excessive or pathological reflexes. Also the Continence, i.e. the ability to defecate and urine at will, disappears completely in this phase.

A so-called Overflow bubble. The urine can no longer be emptied and accumulates in the bladder. The intestines cannot be emptied arbitrarily either, so a Fecal incontinence arises. In addition to these already very stressful symptoms, drops in blood pressure and circulatory shock immediately after paraplegia are feared.

The drop in blood pressure is the result of a widening of vessels. The result can be kidney failure or lung failure. Therefore intensive medical care is necessary. Apart from the physical symptoms, such a drastic event can also lead to psychological consequences, such as depressive symptoms. The spinal shock lasts for a total of several weeks and then turns into the complete paraplegic syndrome.

Symptoms of incomplete paraplegia

The symptoms of incomplete paraplegia are very complicated. It is damage to the spinal cord that does not affect the entire cross-section. A hemiplegic damage that affects either the left or right half of the spinal cord is called a Brown-Séquard syndrome.

Below the damage, the depth sensitivity and the vibration sensation are disturbed on the same side. There is also paralysis of the leg. On the opposite side, however, the pain and temperature sensation is eliminated, which is intact on the side of the damage. However, this scenario is more like a medical construct than actual reality. Damage is often not limited to exactly one side, but also affects structures on the opposite side. Therefore, one often observes a mixed symptomatology, which is not clearly limited to one side.

The acute consequence of a severance of the spinal cord is spinal shockwhich can last from a few hours to several months. This condition is characterized by a flaccid paralysis and lack of sensitivity of the limbs below the damage, a failure of all muscle reflexes and also by disorders of the autonomic nervous system, which are particularly noticeable by the widening of vessels, causing the blood to sink into the legs, the blood pressure drops sharply and it becomes a full picture Shocks can come with circulatory failure.

Usually it works spinal shock after a few weeks into the chronic clinical picture of Paraplegia over. The flaccid paralysis (sagging muscles that can no longer be tensed) gives way to spastic paralysis, which is characterized by the fact that the affected Muscles have an increased basic tension, so they are tense and cramped the whole time.

In the case of complete paralysis, one speaks of Plegia. If the muscle strength is only reduced, but the muscles can still be weakened or tensed at will, this is called a Paresis. In this phase the reflexes are also increased (Hyperreflexia). In the area of ​​paralysis, there are still no sensations, that is, the patient can neither perceive touch, nor the position of his limbs, pain or temperature.

Most often the vegetative recovers Nervous systemafter the spinal shock phase is over, completely or partially. A symptom that persists relatively often is impaired functions of bladder and or Intestineswhich can lead to incontinence. In addition, it is possible for the patient increased sweating or it grows more hair.
Since erection and ejaculation in men are partly controlled via the spinal cord, but partly also as reflexes, in some cases sexual life is unaffected, in other cases it is still possible, but only with restrictions.

Paraplegia is particularly severe if that Spinal cord in the upper area of ​​the cervical spine is damaged as the nerve that is responsible for the function of the Diaphragm is responsible, is severed. As a result, it is no longer possible for the patient to work independently to breathe.

Vegetative consequences of paraplegia

The vegetative symptoms of paraplegia result from damage to the autonomic nervous system. Put simply, this affects functions that for the most part cannot be controlled arbitrarily, but are controlled without active participation.

At the beginning of paraplegia, in the phase of spinal shock, this leads to a drop in blood pressure. In the course of paraplegia, the nervous system counteracts this drop in blood pressure, so that sometimes very stressful blood pressure peaks arise. This is also known as vegetative dysregulation.

Furthermore, there may be sudden flushing or sweating that cannot be controlled by the person concerned. The recurring rise in blood pressure can lead to attack-like headaches. Especially when the bladder or intestines are stretched, the blood pressure derails and skyrockets. As part of the vegetative symptoms, bladder and rectal disorders occur, which are associated with incontinence and emptying disorders, both of the stool and the urine.