quadriplegia

Summary

Summary: Severe or complete loss of motor function in all four limbs which may result from BRAIN DISEASES; SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or rarely MUSCULAR DISEASES. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper BRAIN STEM which injures the descending cortico-spinal and cortico-bulbar tracts.

Top Publications

  1. Beekhuizen K, Field Fote E. Massed practice versus massed practice with stimulation: effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury. Neurorehabil Neural Repair. 2005;19:33-45 pubmed
    ..To determine the effect of massed practice (MP) versus massed practice combined with somatosensory stimulation (MP+SS) on cortical plasticity and function in persons with incomplete tetraplegia...
  2. Soo B, Howard J, Boyd R, Reid S, Lanigan A, Wolfe R, et al. Hip displacement in cerebral palsy. J Bone Joint Surg Am. 2006;88:121-9 pubmed
    ..Knowledge regarding its overall incidence and associated risk factors can facilitate treatment of these children...
  3. Scivoletto G, Tamburella F, Laurenza L, Molinari M. The spinal cord independence measure: how much change is clinically significant for spinal cord injury subjects. Disabil Rehabil. 2013;35:1808-13 pubmed publisher
    ..To calculate the clinical significance of the SCIM III according to distribution-based approaches...
  4. Simeral J, Kim S, Black M, Donoghue J, Hochberg L. Neural control of cursor trajectory and click by a human with tetraplegia 1000 days after implant of an intracortical microelectrode array. J Neural Eng. 2011;8:025027 pubmed publisher
  5. Schessel E, Ger R, Oddsen R. The costs and outcomes of treating a deep pressure ulcer in a patient with quadriplegia ?. Ostomy Wound Manage. 2012;58:41-6 pubmed
    ..A 27-year-old man with a 6-year history of quadriplegia developed an ischial pressure ulcer...
  6. Kalsi Ryan S, Curt A, Verrier M, Fehlings M. Development of the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP): reviewing measurement specific to the upper limb in tetraplegia. J Neurosurg Spine. 2012;17:65-76 pubmed publisher
    ..Primary outcome measures for the upper limb in trials concerning human spinal cord injury (SCI) need to distinguish between functional and neurological changes and require satisfying psychometric properties for clinical application...
  7. Chadwick E, Blana D, Simeral J, Lambrecht J, Kim S, Cornwell A, et al. Continuous neuronal ensemble control of simulated arm reaching by a human with tetraplegia. J Neural Eng. 2011;8:034003 pubmed publisher
    ..These results show the feasibility of combining such an intracortical interface with existing FES systems to provide a high-performance, natural system for restoring arm and hand function in individuals with extensive paralysis...
  8. Chen Y, Cao Y, Allen V, Richards J. Weight matters: physical and psychosocial well being of persons with spinal cord injury in relation to body mass index. Arch Phys Med Rehabil. 2011;92:391-8 pubmed publisher
    ..To examine the relationship of body mass index (BMI) with multiple health indices among persons with spinal cord injury (SCI)...
  9. Yang M, Li J, Zhang S, Du L, Gao F, Li J, et al. Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve. J Neurosurg Spine. 2011;15:190-4 pubmed publisher
    The authors report a case of functional improvement of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization using a functional spinal accessory nerve...

More Information

Publications68

  1. Hochberg L, Bacher D, Jarosiewicz B, Masse N, Simeral J, Vogel J, et al. Reach and grasp by people with tetraplegia using a neurally controlled robotic arm. Nature. 2012;485:372-5 pubmed publisher
  2. Berlowitz D, Spong J, Gordon I, Howard M, Brown D. Relationships between objective sleep indices and symptoms in a community sample of people with tetraplegia. Arch Phys Med Rehabil. 2012;93:1246-52 pubmed publisher
    ..To examine the relationships between injury severity, quality of life, sleep symptoms, objectively measured sleep, and sleep disorders in chronic tetraplegia...
  3. Aldahmesh M, Mohamed J, AlKuraya H, Verma I, Puri R, Alaiya A, et al. Recessive mutations in ELOVL4 cause ichthyosis, intellectual disability, and spastic quadriplegia. Am J Hum Genet. 2011;89:745-50 pubmed publisher
    ..Our findings identify recessive mutations in ELOVL4 as the cause of a neuro-ichthyotic disease and emphasize the importance of VLCFA synthesis in brain and cutaneous development...
  4. Kowalczewski J, Chong S, Galea M, Prochazka A. In-home tele-rehabilitation improves tetraplegic hand function. Neurorehabil Neural Repair. 2011;25:412-22 pubmed publisher
    ..Functional electrical stimulation (FES) combined with exercise therapy (ET) can improve hand function, but delivering the treatment is problematic...
  5. Panichpisal K, Gandhi S, Nugent K, Anziska Y. Acute quadriplegia from hyperkalemia: a case report and literature review. Neurologist. 2010;16:390-3 pubmed publisher
    Hyperkalemia has been described as a rare and under recognized cause of acute quadriplegia.
  6. Hoffman L, Field Fote E. Functional and corticomotor changes in individuals with tetraplegia following unimanual or bimanual massed practice training with somatosensory stimulation: a pilot study. J Neurol Phys Ther. 2010;34:193-201 pubmed publisher
    ..However, bimanual training may be more beneficial as these individuals have bilateral impairment. We compared clinical and corticomotor changes associated with unimanual versus bimanual MP training, each combined with SS...
  7. Kim S, Simeral J, Hochberg L, Donoghue J, Friehs G, Black M. Point-and-click cursor control with an intracortical neural interface system by humans with tetraplegia. IEEE Trans Neural Syst Rehabil Eng. 2011;19:193-203 pubmed publisher
    ..This study suggests that signals from a small ensemble of motor cortical neurons (∼40) can be used for natural point-and-click 2-D cursor control of a personal computer. ..
  8. Bitar Alatorre W, Segura Torres J, Rosales Corral S, Jiménez Avila J, Huerta Viera M. Quadriplegia recovery after hemi-section and transplant model of spinal cord at the level of C5 and C6. Neurosci Lett. 2011;491:18-22 pubmed publisher
    ..the histological characteristics such as quantity and quality of axons, myelin index and blood vessels after quadriplegia recovery...
  9. Laureys S, Pellas F, van Eeckhout P, Ghorbel S, Schnakers C, Perrin F, et al. The locked-in syndrome : what is it like to be conscious but paralyzed and voiceless?. Prog Brain Res. 2005;150:495-511 pubmed
    ..In our opinion, there is an urgent need for a renewed ethical and medicolegal framework for our care of locked-in patients...
  10. Muller Putz G, Scherer R, Pfurtscheller G, Rupp R. EEG-based neuroprosthesis control: a step towards clinical practice. Neurosci Lett. 2005;382:169-74 pubmed
    ..The fact that the user learned to control the BCI in a comparatively short time indicates that this method may also be an alternative approach for clinical purposes...
  11. Berlowitz D, Spong J, Pierce R, Ross J, Barnes M, Brown D. The feasibility of using auto-titrating continuous positive airway pressure to treat obstructive sleep apnoea after acute tetraplegia. Spinal Cord. 2009;47:868-73 pubmed publisher
    ..A prospective cohort with acute tetraplegia...
  12. Høyer E, Normann B, Sørsdal R, Strand L. Rehabilitation including treadmill therapy for patients with incomplete locked-in syndrome after stroke; a case series study of motor recovery. Brain Inj. 2010;24:34-45 pubmed publisher
    ..The aim of this study was to explore changes in motor function in patients with incomplete LIS referred to rehabilitation...
  13. New P, Thomas S. Cognitive impairments in the locked-in syndrome: a case report. Arch Phys Med Rehabil. 2005;86:338-43 pubmed
    ..Neuropsychologic testing in this patient suggests that the LIS may be associated with impairments of higher-level cognitive functioning...
  14. Abhishek A, Anushree A, Patir R, Sehgal A. Extreme lateral approach in a case of acute-onset quadriplegia due to high cervical neurenteric cyst. Pediatr Neurosurg. 2007;43:134-6 pubmed
    ..We report an 18-year-old male who presented with a rapid onset of respiratory distress and quadriplegia over a period of 6 h requiring intubation and ventilatory support...
  15. Kim S, Simeral J, Hochberg L, Donoghue J, Black M. Neural control of computer cursor velocity by decoding motor cortical spiking activity in humans with tetraplegia. J Neural Eng. 2008;5:455-76 pubmed publisher
    ..Performance assessment based on standard metrics used for the evaluation of a wide range of pointing devices demonstrated significantly improved cursor control with velocity rather than position decoding...
  16. Ochala J, Larsson L. Effects of a preferential myosin loss on Ca2+ activation of force generation in single human skeletal muscle fibres. Exp Physiol. 2008;93:486-95 pubmed publisher
    ..Thus, a change in Ca(2+) activation of the contractile apparatus in patients with preferential myosin loss is proposed as an additional factor contributing to the muscle function impairment in these patients...
  17. Schnakers C, Majerus S, Goldman S, Boly M, van Eeckhout P, Gay S, et al. Cognitive function in the locked-in syndrome. J Neurol. 2008;255:323-30 pubmed publisher
    ..Classically, communication remains possible by means of spared vertical eye movements and/or blinking. To allow assessing cognitive functions in LIS patients, we propose here a neuropsychological testing based on eye-coded communication...
  18. Shimada Y, Chida S, Matsunaga T, Misawa A, Ito H, Sakuraba T, et al. Grasping power by means of functional electrical stimulation in a case of C6 complete tetraplegia. Tohoku J Exp Med. 2003;201:91-6 pubmed
  19. Lule D, Zickler C, Hacker S, Bruno M, Demertzi A, Pellas F, et al. Life can be worth living in locked-in syndrome. Prog Brain Res. 2009;177:339-51 pubmed publisher
    ..Novel communication devices and assistive technology now offers an increasing number of LIS patients to resume a meaningful life and an active role in society...
  20. Leemann B, Schnider A. [Unusually favorable recovery from locked-in syndrome after basilar artery occlusion]. Rev Med Suisse. 2010;6:633-5 pubmed
    ..We describe a case with remarkable recovery. After 2 years the patient was independent for daily living activities, walks independently and has comprehensible speech...
  21. Coates S, Harvey L, Dunlop S, Allison G. The AuSpinal: a test of hand function for people with tetraplegia. Spinal Cord. 2011;49:219-29 pubmed publisher
    ..Five-phased reliability and validity study...
  22. Man D, Wong M. Evaluation of computer-access solutions for students with quadriplegic athetoid cerebral palsy. Am J Occup Ther. 2007;61:355-64 pubmed
    ..The WinFitts and Assessment of Comfort tests used in this study can be replicated for further clinical research into computer-access systems...
  23. Gordon G, Simkiss D. A systematic review of the evidence for hip surveillance in children with cerebral palsy. J Bone Joint Surg Br. 2006;88:1492-6 pubmed
    ..Surveillance can identify children most at risk of subluxation using radiological methods which are widely available...
  24. Chen H, Tsai C, Lee J, Chen C, Chang F. Acute quadriplegia complicating critical illness polyneuropathy in a patient with infective endocarditis: a case report. J Infect. 2005;50:153-7 pubmed
    A 75-year-old woman with infective endocarditis developed critical illness polyneuropathy (CIP) with quadriplegia after cardiac surgery...
  25. Smith E, Delargy M. Locked-in syndrome. BMJ. 2005;330:406-9 pubmed
  26. Rudhe C, van Hedel H. Upper extremity function in persons with tetraplegia: relationships between strength, capacity, and the spinal cord independence measure. Neurorehabil Neural Repair. 2009;23:413-21 pubmed publisher
    ..To quantify the relationship between the Spinal Cord Independence Measure III (SCIM III), arm and hand muscle strength, and hand function tests in persons with tetraplegia...
  27. Norman H, Kandala K, Kolluri R, Zackrisson H, Nordquist J, Walther S, et al. A porcine model of acute quadriplegic myopathy: a feasibility study. Acta Anaesthesiol Scand. 2006;50:1058-67 pubmed
    ..Accordingly, there is a need for relevant experimental animal models aimed at identifying underlying mechanisms...
  28. Hochberg L, Serruya M, Friehs G, Mukand J, Saleh M, Caplan A, et al. Neuronal ensemble control of prosthetic devices by a human with tetraplegia. Nature. 2006;442:164-71 pubmed
    ..These early results suggest that NMPs based upon intracortical neuronal ensemble spiking activity could provide a valuable new neurotechnology to restore independence for humans with paralysis...
  29. Kalita J, Misra U, Mahadevan A, Shankar S. Acute pure motor quadriplegia: is it dengue myositis?. Electromyogr Clin Neurophysiol. 2005;45:357-61 pubmed
    In view of paucity of comprehensive evaluation about dengue infection producing quadriplegia, we report the clinical, laboratory and neurophysiological studies in these patients.
  30. Onders R, Khansarinia S, Weiser T, Chin C, Hungness E, Soper N, et al. Multicenter analysis of diaphragm pacing in tetraplegics with cardiac pacemakers: positive implications for ventilator weaning in intensive care units. Surgery. 2010;148:893-7; discussion 897-8 pubmed publisher
    ..Diaphragm pacing (DP) can replace mechanical ventilation in tetraplegics and in trials has assisted respiration in amyotrophic lateral sclerosis patients. This report describes results of DP in patients with cardiac pacemakers...
  31. Bose S, Ali Z, Rath G, Prabhakar H. Spontaneous spinal epidural haematoma: a rare cause of quadriplegia in the post-partum period. Br J Anaesth. 2007;99:855-7 pubmed
    ..However, SSEH with associated myelitis presenting as quadriplegia and respiratory paralysis in the post-partum period has never been reported...
  32. Mangold S, Keller T, Curt A, Dietz V. Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury. Spinal Cord. 2005;43:1-13 pubmed
    ..Case series...
  33. DiMarco A, Onders R, Ignagni A, Kowalski K, Mortimer J. Phrenic nerve pacing via intramuscular diaphragm electrodes in tetraplegic subjects. Chest. 2005;127:671-8 pubmed
    ..However, this technique may be accomplished less invasively via laparoscopic placement of IM electrodes, at a lower cost and with less risk of injury to the phrenic nerve...
  34. Terjesen T, Lie G, Hyldmo A, Knaus A. Adductor tenotomy in spastic cerebral palsy. A long-term follow-up study of 78 patients. Acta Orthop. 2005;76:128-37 pubmed
    ..There is a risk of hip dislocation in children with spastic cerebral palsy. We evaluated the prophylactic effect of adductor tenotomy in patients with long-term follow-up...
  35. Berlowitz D, Brown D, Campbell D, Pierce R. A longitudinal evaluation of sleep and breathing in the first year after cervical spinal cord injury. Arch Phys Med Rehabil. 2005;86:1193-9 pubmed
    ..To establish the incidence of sleep disordered breathing (SDB) after acute tetraplegia and to determine the relation between the Apnea-Hypopnea Index (AHI) score and the previously postulated predictors of SDB in tetraplegia...
  36. Snoek G, IJzerman M, Post M, Stiggelbout A, Roach M, Zilvold G. Choice-based evaluation for the improvement of upper-extremity function compared with other impairments in tetraplegia. Arch Phys Med Rehabil. 2005;86:1623-30 pubmed
  37. Chen C, Lu C, Chen N. Spontaneous spinal epidural hematoma presenting with quadriplegia after sit-ups exercise. Am J Emerg Med. 2009;27:1170.e3-7 pubmed publisher
    ..3% to 0.9% of spinal epidural space-occupying lesions, and most surgeons advocate aggressive and early surgical intervention. In this article, we describe a patient with SSEH with sudden quadriplegia after sit-ups exercise.
  38. Robbins M, Verghese J. Acute painless progressive quadriplegia associated with warfarin use. J Am Geriatr Soc. 2007;55:799-800 pubmed
  39. Rupp R, Gerner H. Neuroprosthetics of the upper extremity--clinical application in spinal cord injury and challenges for the future. Acta Neurochir Suppl. 2007;97:419-26 pubmed
    ..The possibility of direct brain control of FES systems will extend the application of grasp neuroprostheses to patients with injuries of the highest cervical spinal cord...
  40. Beigmohammadi M, Aghdashi M, Najafi A, Mojtahedzadeh M, Karvandian K. Quadriplegia due to lead-contaminated opium--case report. Middle East J Anaesthesiol. 2008;19:1411-6 pubmed
    Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia.
  41. Tubbs R, Pearson B, Loukas M, Shokouhi G, Shoja M, Oakes W. Phrenic nerve neurotization utilizing the spinal accessory nerve: technical note with potential application in patients with high cervical quadriplegia. Childs Nerv Syst. 2008;24:1341-4 pubmed publisher
    High cervical quadriplegia is associated with high morbidity and mortality. Artificial respiration in these patients carries significant long-term risks such as infection, atelectasis, and respiratory failure...
  42. Larsson L. Experimental animal models of muscle wasting in intensive care unit patients. Crit Care Med. 2007;35:S484-7 pubmed
    ..e., models designed to determine the mechanisms underlying the muscle wasting associated with ICU treatment)...
  43. Truccolo W, Friehs G, Donoghue J, Hochberg L. Primary motor cortex tuning to intended movement kinematics in humans with tetraplegia. J Neurosci. 2008;28:1163-78 pubmed publisher
  44. Ruzek K, Campeau N, Miller G. Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging. AJNR Am J Neuroradiol. 2004;25:210-3 pubmed
  45. Saitsu H, Tohyama J, Kumada T, Egawa K, Hamada K, Okada I, et al. Dominant-negative mutations in alpha-II spectrin cause West syndrome with severe cerebral hypomyelination, spastic quadriplegia, and developmental delay. Am J Hum Genet. 2010;86:881-91 pubmed publisher
    ..These findings suggest that pathological aggregation of alpha/beta spectrin heterodimers and abnormal AIS integrity resulting from SPTAN1 mutations were involved in pathogenesis of infantile epilepsy...
  46. Chen H, Chen C, Lu C, Wu C. Pointing device usage guidelines for people with quadriplegia: a simulation and validation study utilizing an integrated pointing device apparatus. IEEE Trans Neural Syst Rehabil Eng. 2009;17:279-86 pubmed publisher
    ..The priority for selecting which body part should control the pointing devices was as follows: unilateral hands, unilateral wrist/hands, and either bilateral body parts or a limb and chin/head/neck in combination...
  47. Beekhuizen K, Field Fote E. Sensory stimulation augments the effects of massed practice training in persons with tetraplegia. Arch Phys Med Rehabil. 2008;89:602-8 pubmed publisher
  48. Itzkovich M, Gelernter I, Biering Sorensen F, Weeks C, Laramee M, Craven B, et al. The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study. Disabil Rehabil. 2007;29:1926-33 pubmed
    ..To examine the third version of the Spinal Cord Independence Measure (SCIM III) for reliability and validity in a multi-center cohort study...
  49. Sadanand V, Kelly M, Varughese G, Fourney D. Sudden quadriplegia after acute cervical disc herniation. Can J Neurol Sci. 2005;32:356-8 pubmed
    ..In most cases, acute symptoms were due to progression of disc herniation in the presence of pre-existing spinal canal stenosis...
  50. Muthukumar N. Anterior cervical arachnoid cyst presenting with traumatic quadriplegia. Childs Nerv Syst. 2004;20:757-60 pubmed
    ..Intraduralspinal arachnoid cysts are rare. Rarer still are cysts located anteriorto the cervical spinal cord. To date,only 10 such cases have been re-ported in the English-language liter-ature...
  51. Wilson J, Nordal H. EEG in connection with coma. Tidsskr Nor Laegeforen. 2013;133:53-7 pubmed publisher
    ..Repeated EEG scans increase diagnostic certainty and make it possible to monitor the development of coma. EEG reflects brain function continuously and therefore holds a key place in the assessment and treatment of coma. ..
  52. Sabour H, Javidan A, Ranjbarnovin N, Vafa M, Khazaeipour Z, Ghaderi F, et al. Cardiometabolic risk factors in Iranians with spinal cord injury: analysis by injury-related variables. J Rehabil Res Dev. 2013;50:635-42 pubmed
    ..Patients with paraplegia may have increased hypertension, higher BMI, and increasing levels of serum LDL-C and TC than those with tetraplegia. Conventional risk factors for CHD should be identified and treated in individuals with SCI. ..
  53. Misirlioglu T, Unalan H, Karamehmetoglu S. Validation of Duruöz Hand Index in patients with tetraplegia. J Hand Ther. 2016;29:269-74 pubmed publisher
    ..UEMS), neurologic level of injury and visual analogue scale of hand function (VAS-HF)], 'activity' [DHI and Quadriplegia index of function-short form (QIF-SF)] and 'body function and structure, activity and participation' [Health ..
  54. Onders R, Ponsky T, Elmo M, Lidsky K, Barksdale E. First reported experience with intramuscular diaphragm pacing in replacing positive pressure mechanical ventilators in children. J Pediatr Surg. 2011;46:72-6 pubmed publisher
    ..The remaining patients weaned from the ventilator for over 14 hours a day and/or are actively conditioning their diaphragms. Diaphragm pacing successfully replaced mechanical ventilators, which improves quality of life. ..
  55. Ajiboye A, Hochberg L, Donoghue J, Kirsch R. Application of system identification methods for decoding imagined single-joint movements in an individual with high tetraplegia. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:2678-81 pubmed publisher
    ..We report rates of 25 - 50% for predicting completely imagined arm movements in the absence of a priori movements to aid in decoder building. ..
  56. Lancioni G, Singh N, O Reilly M, Sigafoos J, Oliva D, Campodonico F, et al. Persons with multiple disabilities exercise adaptive response schemes with the help of technology-based programs: three single-case studies. Res Dev Disabil. 2012;33:849-57 pubmed publisher
    ..The importance of using technology-based programs as tools for enabling persons with profound and multiple disabilities to practice relevant responses independently was discussed. ..
  57. Santra G, De D, Sinha P. Hypokalemic periodic paralysis due to proximal renal tubular acidosis in a case with membranoproliferative glomerulonephritis. J Assoc Physicians India. 2011;59:735-7 pubmed
    ..Kidney biopsy showed membranoproliferative glomerulonephritis with tubulointerstitial damage. Hypokalemic periodic paralysis and pRTA are uncommon associations of membranoproliferative glomerulonephritis...
  58. Marvulli R, Chiumarulo P, Nisi M, Barulli L, Megna G, Pietro F, et al. Use Of External Intrathecal Infusion Pumps In The Management Of Septic Complications: A Case Report. Endocr Metab Immune Disord Drug Targets. 2015;15:293-6 pubmed
    ..In this study, we evaluated clinical improvement after complete healing of the septic focus and implantation of a new infuser. ..
  59. Wöllner J, Pannek J. Sacral neuromodulation: No more skiing?. Scand J Urol. 2016;50:132-3 pubmed publisher
    ..Trauma due to skiing is a potential risk factor for the integrity of SNM. Patients with SNM should be informed about the potential risk of SNM damage by falls and accidents. ..