Talk:Tetraplegia
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Comparison
editThis article should say how this compares with Paraplegia. I don't know enough detail.
- Short, possibly oversimplified, version: paraplegia is from the waist down, quadriplegia is from the neck down. --Paul A 07:58, 19 Feb 2004 (UTC)
No, Paul. Waist down/neck down is not the difference. Paraplegia is paralysis affecting two limbs, quadriplegia is paralysis affecting four limbs. Neither term means total paralysis of the limb (i.e. a person paralyzed in the feet but not the knees is a para. Also, many quads can use their arms because the paralysis is not total. Triceps, biceps, wrist flexors, wrist extensors, finger, etc. will have different functionality in each quad depending on how high up the cervical spine is injured.)]]
- The introduction now does a slightly better job of defining quadriplegia as well as comparing it to paraplegia. Hananekosan (talk) 08:15, 18 August 2009 (UTC)
Possible ways of treatment or if/why treatment is not possible
editI would like to know if the condition of being tetraplegic or quadriplegic can not be fixed in principle, or if it could be fixed in principle but not in practice because medicine is not advanced enough yet? As I understand it, the nerves in the spine are cut and this is the reason why those patients can not move their extremities which are controlled by these nerves; I wonder if (a) through a form of "microsurgery" the severed nerves could be fixed together again? Or (b) if by use of microprocessors and wires, if it would be possible to "bypass" the severed sections of nerve? (I am not an MD so please excuse if my wording sounds a little naive). I do understand that nerves are extremely thin, that it is difficult to figure out which nerve before the "break" belongs to which nerve after it, but its' not like we are living in the dark ages, todays microscopes and surgical instruments are advanced enough that surgery on nerves should be possible I believe. so what is the reason why this condition can not be fixed? I think the article should mention that. also I would like to know because I have been wondering about this for years. —Preceding unsigned comment added by 210.230.134.160 (talk) 17:12, 11 May 2009 (UTC)
Tetraplegic? and term definitions
editParaplegia says: "If the arms are also affected by paralysis, tetraplegia is the proper terminology."
Which also agrees with the article I got in email, which says: with a chest infection, a complication from a spinal cord injury he sustained in September, 2003 that left him a tetraplegic (paralyzed below the ribcage with limited use of his upper body).
~ender 2008-02-28 21:28:PM MST
Quadriplegia is the common american term for the condition. In europe and medical circle it is known at tetraplegia.
Quadriplegia from latin root quad meaning four and greek root plegia meaning paralysis.
Tetraplegia from greek roots tetra meaning four and plegia.
The article should really be renamed. Ghym (talk) 12:26, 19 November 2009 (UTC)
Removed this line cause Superman is now in heaven.
editIn some rare cases, through intensive rehabilitation, slight movement can be regained, as in the case of actor Christopher Reeve.
Wolfgang Schäuble
editI've removed Wolfgang Schäuble from the list of quadriplegics, as the article says he was paralysed from the waist, therefore making him a paraplegic Graham 09:56, 13 Jun 2005 (UTC)
hey
editIs there a cure or treatment that you could give someone so that if they were quad that they would be able to move?
- Depends on the cause of the quadriplegia, but generally the answer is "no". JFW | T@lk 22:23, 30 January 2006 (UTC)
Mark Zupan
editIsn't he a paraplegic? Kind of hard to play murderball without your arms, no?
- As the article mentions, being tetraplegic doesn't mean you have no use of your arms, it could be just partial loss. Indeed Mark Zupan must be tetraplegic as it is a requirement for wheelchair rugby, it was evidently one of the reasons for the invention of wheelchair rugby as the article discusses... Nil Einne 14:40, 15 September 2006 (UTC)
- The scene where he is getting dressed clearly shows that his hands are affected. Roger (talk) 18:59, 19 November 2009 (UTC)
Not always complete
editI edited this to say partial or complete paralysis from the neck down. Quadriplegia is a disability where all four limbs are affected, but it does not necessarily imply total paralysis. Mark Zupan, for example, is definitely a quadriplegic, although he retains some arm function.
One decent working definition, at least as it relates to spinal cord injuries, is that paras break their backs while quads break their necks. That is, someone with quadriplegia has sustained an injury to the cervical spine. This can lead to near-total paralysis à la Christopher Reeve if it is a high injury, but those with lesions lower down the cervical spine can retain some function in their arms and hands. Eron 22:47, 12 March 2006 (UTC)
Famous persons
editPer Wikipedia:Biographies of living persons I removed the famous persons section since it was completely unsourced. Here is the diff [1] if people want to check it out and source those entries. Garion96 (talk) 02:18, 30 December 2006 (UTC)
- I really have a problem with this. Most of those people listed have articles on Wikipedia which clearly state that they are quadriplegic, and which reference that fact. For several of them, their notability is tied to their disability, and no one would dispute that they are actually disabled. What exactly is the issue with listing them here? - Eron Talk 03:23, 30 December 2006 (UTC)
- If they have sources on the corresponding articles it should be easy to source them here. However the {{verify}} tag has been on there for ages and no one sourced them. Besides, it's not really necessary to have a list of famous persons on the actual sympton page (IMO). Garion96 (talk) 03:57, 30 December 2006 (UTC)
- I support Garion96's removal actions here, as do the three "nutshell" points in WP:VERIFY. Let's leave the issue of where to list the people for another time, though. Please restore only sourced names (and Wikipedia is not a source). WP:MEDMOS has some guidelines. Colin°Talk 20:45, 30 December 2006 (UTC)
Regarding the removal of living persons citing WP:BLP: that policy states, in part, "editors should remove any controversial material about living persons that is either unsourced, relies upon sources that do not meet standards specified in Wikipedia:Reliable sources, or is a conjectural interpretation of a source." (emphasis added). Can I ask what is controversial about the statement that Stephen Hawking is a quadriplegic? - Eron Talk 15:49, 10 January 2007 (UTC)
- It is controversial to state that someone is a quadriplegic without sources. That's all. For some people Stephen Hawking is unknown but they are sure that person X is quadriplegic, but don't have a source for it and since Person Y also has no source why is it necessary etc etc.. It's so much better just to source it. If I had better computer access here I would find a source myself since it really should not be so hard to find a source for that. Garion96 (talk) 17:45, 10 January 2007 (UTC)
- My question is, why is it controversial? What is it about quadriplegia that makes it a controversial statement, more so than "Stephen Hawking is male" or "Stephen Hawking is white" or or "Stephen Hawking is British"? Please understand that I'm not trying to be difficult here; it's just that there seems to be a point at which a statement about a living person crosses a line and is considered controversial. I'm trying to understand where that point is. - Eron Talk 17:56, 10 January 2007 (UTC)
- It's not that easy to define. But I would think that stating that someone has a sickness or a physical disability is generally considered controversial. There is/was a discussion about it here. Garion96 (talk) 04:32, 29 January 2007 (UTC)
- My question is, why is it controversial? What is it about quadriplegia that makes it a controversial statement, more so than "Stephen Hawking is male" or "Stephen Hawking is white" or or "Stephen Hawking is British"? Please understand that I'm not trying to be difficult here; it's just that there seems to be a point at which a statement about a living person crosses a line and is considered controversial. I'm trying to understand where that point is. - Eron Talk 17:56, 10 January 2007 (UTC)
Absolutely major expansion of quadriplegia and paraplegia is needed
editFirst of all, the anatomy and physiology of the spinal column is needed. Roughly the neck is called the CERVICAL spine, the spinal verterbae attached to ribs are the THORACIC spine, and the larger vertebrae between the ribcage and the pelvis are the LUMBAR spine. Second, the extent of injury and the immediate treatment absolutely predict the ultimate outcome in terms of the level of neurological impairment. That is, almost NO spinal injury involves total obliteration of the spinal cord. It is useful to think of the passage through all of the vertebral bones--called the foramen. When one vertebra moves against another (an injury event) the displacement may damage the nerves of the spinal column. Trauma care involves the immediate re-alignment of the vertebrae. Greater mis-alignment and for longer periods predicts greater levels of long term, permanent impairment. Keep in mind that there are vascular structures, as well, passing through the foramen, and misalignmnets will interrupt circulation, thus deteriorating normal neurological conduction of the afferent and efferent nerves of the spinal cord. Thus, "recovery" from spinal cord injury has far more to do with the first minutes after a trauma event--subsequent treatments by physiatrists (physical medicine and rehabilitation physicians), rehabilitation registered nurses and physical therapists (physiotherapists) involve primarily management of the SCI (spinal cord injury) disability. Even with full recovery, the initial days or weeks of impairment must be handled with meticulous competence to avoid corollary difficulty with urinary/kidney complications, pressure sore complications, and joint contractures. The emotional management of the life-changing paralysis (since it is not known if it is a permanent or temporary disability) is important, as well. Note that many trauma events are co-incident with significant human error and it could be argued that many SCI-ed persons might have played a larger role in preventing the injuries. Thus, guilt and self-blaming are common responses of a notable percentage of patients. Nerve impairment of the spinal column has an obvious relationship to all physiological functions below the point of injury, most notably bowel and bladder function (including a sense of "fullness") and sexual function, most easily noted in the unpredictability or absence of erectile function. So, we have a lot of work to do here. HomeBuilding207.178.98.45 14:31, 5 May 2007 (UTC)
Causes other than SCI
editThis article only discusses SCI in any depth and completely fails to mention a number of significant causes such as multiple sclerosis, various types of distrophy, ALS, polio, etc. Roger (talk) 20:30, 8 May 2009 (UTC)
"Complete" versus "Incomplete" classification; "Symptom" and other issues
editI am by no means an expert in this area but I agree that there is a lot of work to be done on this topic. Just off the top of my head, the initial statement that quadriplegia is a "symptom" is inaccurate. It's not a symptom (something subjectively reported by the patient) at all. Additionally, there are issues with the concept of "complete" and "incomplete." According to the American Spinal Injury Association (ASIA) Classification guidelines, with SCI, the clinical definition of "complete" or "incomplete" has nothing to do with whether the spinal cord was partially or completely severed or is intact. A "complete" SCI means that there is no sensation at the anal spinchter; "incomplete" means there is. Being "complete" or "incomplete" can each occur when the spinal cord is wholly, partially, or not at all severed. But then there is also the difference between partial and complete paralysis, as the article presently touches upon. Somewhere (between this topic, the paraplegia topic, and any topics on the causes of tetraplegia and paraplegia), we should consider differentiating between these different meanings of "complete" and "incomplete." I agree that the article is very much lacking in information on non-SCI causes. Transverse myelitis also comes to mind.
This article (http://sci.rutgers.edu/index.php?page=viewarticle&afile=24_June_2003@SpinalLevels.html ) by Wise Young, Ph.D., M.D. helps to clarify some of the classification issues. It also covers the anatomy that someone already commented is needed in this topic.
Tetraplegia is the correct, current term, BTW, so we should make that clear as well. Hananekosan (talk) 02:34, 5 August 2009 (UTC)
- I updated the intro and the issue of quadraplegia/tetraplegia being described as a symptom has been fixed but these other issues still remain. I also updated the "symptoms" heading to "symptoms, signs and complications" as the section covers all three. Hananekosan (talk) 08:15, 18 August 2009 (UTC)
OMIM 603513 ?
editIf it is, add to the template. --CopperKettle 10:25, 14 August 2009 (UTC)
Causes
editAlso needs revision as "lesion" really only applies to injury to the spinal cord. As pointed out previously, non-traumatic causes need much more coverage in this article and this section is the logical place for it. More information on brain injury should be considered as well. Hananekosan (talk) 08:15, 18 August 2009 (UTC)
Prognosis
editShould give a more balanced view of what tetras at various levels can do, such as drive with controls, work, and so forth.
Should cover rehabilitation, why it's so important, what CARF accreditation and being a Model SCI Rehab mean, what is taught (ADL adaptations, transfers, physical therapy...).
Should stress the importance of physical therapy and exercise in helping to preserve bone and muscle mass, as well as a balanced view of the return of function that sometimes naturally occurs within two years of onset, as well as due to intensive therapy and exercise for higher and lower levels and those with varying degrees of damage. (Some of this information applies regardless of the cause of the paralysis, but some is particular to SCIs only so might be more appropriate for the SCI article.) Hananekosan (talk) 08:15, 18 August 2009 (UTC)
Requested move
edit- The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.
The result of the move request was: Page moved. Correct term, and common enough English usage outside the US. -- Hadal (talk) 23:23, 1 July 2011 (UTC)
Quadriplegia → Tetraplegia – The American Spinal Cord Injury Classification system has advised the correct term to be Tetraplegia, it has become uncommon for the medical community in the United States to use the old term Quadripegia, the US is the only country where the layman term is still used among common people and referring to the old term as the article title only will only further the inconsistency among general population and the medical community. Please see the articles Terminology section for further detail. A redirect from Quadriplegia to Tetraplegia will still enable the laymen term to be used in searches. 138.199.74.72 (talk) 00:05, 24 June 2011 (UTC)
- Oppose I see it in Canada, so I don't see how the US is the only place that uses the layman's term for the condition. This seems to be WP:ENGVAR violation by claiming that US usage is to be ignored. 65.94.47.63 (talk) 04:19, 24 June 2011 (UTC)
- Support The international accepted term is tetraplegia, the medical correct term is tetraplegia. — Preceding unsigned comment added by 27.100.18.86 (talk) 04:58, 24 June 2011 (UTC)
- Support I am surprised that Quadriplegia is still used. Mixing Latin and Greek has always been considered a faux pas. A Wikipedia article should use correct medical terminology. Here in the UK tetraplegia is used exclusively. 31.6.22.123 (talk) 05:45, 30 June 2011 (UTC)
- The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.
Research
editNeeds a section on current research on treatments, such as stem cell therapy or bionic limbs. — Preceding unsigned comment added by 184.162.143.146 (talk) 03:46, 7 November 2013 (UTC)
Can we please get a list of pharmaceuticals used to treat tetraplegics and the symptoms they are prescribed for? — Preceding unsigned comment added by 122.60.171.74 (talk) 10:27, 26 October 2014 (UTC)
Diet requirements for an individual with tetraplegia
editI believe this article would benefit from having dietary recommendations for a person in this condition. Perhaps a caretaker is seeking dietary information for an individual who is lucky enough to be able to consume food via their mouth and/or recommendations for parental nutrition. For example, I would assume a sedentary lifestyle would require a great reduction in carbohydrate intake and an increase in protein. Are there certain supplements that a tetraplegic patient should be utilizing? Thoughts?PaulaY 01:07, 3 August 2015 (UTC) — Preceding unsigned comment added by PaulaY (talk • contribs)
Please fix formatting and missing information
editWhat's up with the "infobox" in the introduction? It doesn't look like it belongs there. Where is the beginning of the text that begins at the bottom of the infobox? "The loss is usually sensory and motor, which means that both sensation and control are lost." is not the first sentence of an introduction. I came here to check what tetraplegia is, and this is no help at all. — Preceding unsigned comment added by Emicattt (talk • contribs) 12:34, 24 February 2017 (UTC)
Wiki Education assignment: WikiProject Medicine Fall 2022 UCF COM
editThis article was the subject of a Wiki Education Foundation-supported course assignment, between 24 October 2022 and 18 November 2022. Further details are available on the course page. Student editor(s): Tdaprano (article contribs).
— Assignment last updated by DLEMERGEBM (talk) 19:04, 27 October 2022 (UTC)
Hello, I am a 4th-year medical student. I will be organizing this wiki page and adding additional information as part of a school course. Hopefully I am able to clean this page up and this page can better represent the condition.
Currently on my to-do list is the following:
- Adding pictures as the current page exists in text form only
- Adjusting infobox information to be more accurate
- Adding background information to the opening paragraph so that it better characterizes tetraplegia
- Expanding the anatomical references and organizing the current section to better represent the different challenges associated with the neurological level of injury
- ASIA scoring form for SCI and expand on the current explanation on the page
- Organize and expand on the etiologies listed. Non traumatic etiologies are briefly listed in one of the lines but make up a major cause of SCI and need more expansion
- Adding additional references and citations to back up claims made on the page
- General re-formatting of the page. Most of the page is in single paragraph text form and could be made easier to read with additional formatting
Note on "Not to be confused with spastic tetraplegia"
editI would like to note someone added a link to the spastic tetraplegia page with "Not to be confused with spastic tetraplegia" at the top of this article. Spastic tetraplegia itself is a type of tetraplegia so redirecting users to a secondary article immediately is redundant. If you would like to bring attention to the distinction between spastic tetraplegia and flaccid tetraplegia, this is best done in a section of the page and linking the "spastic tetraplegia" page. It is also important to note many SCI patients develop spasticity complications during their post-injury course.
Note on "Complete spinal-cord lesions" subsection
editThis section contains minutia relating to spinal cord anatomy that inadequately describes a complete SCI in terms the public is familiar with and, to be frank, most physicians will also have poor familiarity with these terms. I will be looking for alternate terminology to use here in an attempt to make this easier to digest. I will also try to add more content that describes a complete SCI. The terms here are far more in depth than necessary and a picture would be massively helpful in understanding the referenced spinal cord anatomy.
--Tdaprano (talk) 18:40, 27 October 2022 (UTC)
Above action items have been completed. Please let me know if there are any issues with the new, updated changes. Hopefully this article will now be able to better inform future readers of the condition. Tdaprano (talk) 01:06, 19 November 2022 (UTC)