Tetraparesis

What is tetraparesis?

Tetraparesis or quadriparesis is a condition in which the patient’s four limbs suffer from muscle weakness. Some patients may not be able to control motor function of their limbs, while others may experience partial paralysis of some of their limbs. Tetraparesis can come in both spastic (unusual stiffness or tightness of muscles and tendons) and flaccid (the muscles become limp) varieties.

Variations

Complete paralysis of all four limbs is known as tetraplegia or quadriplegia. Muscle weakness of the legs, but not the arms, is called paraparesis, while complete paralysis of the legs is known as paraplegia.

What is the outlook for patients with tetraparesis?

There are several possible causes of tetraparesis, some of which are treatable, while others will affect the patient for the rest of their life.

Symptoms of tetraparesis

Tetraparesis can itself be a symptom of various conditions. Its main characteristics are:

• Muscle weakness
• Paralysis of certain limbs or parts of certain limbs
• Lack of motor control
• Poor or absent tendon reflexes

Other possible effects include:

• Loss of bladder or bowel control
• Loss of sexual function
• Difficulty breathing

What are the causes of tetraparesis?

The muscle weakness is caused when the nerve impulses passing along the spinal cord are partially interrupted. As a result of this, the muscles connected to these nerves do not function properly.

There are several possible causes of tetraparesis. Most involve some sort of nerve compression or damage, but in other cases it is symptomatic of a degenerative condition:

• Congenital tetraparesis – the condition is present from birth. Cerebral palsy is the most common congenital condition that causes tetraparesis.
• Neurological degeneration can cause spastic tetraparesis
• Spinal trauma that damages the spinal cord, such as those that cause the intervertebral discs to rupture
• Acute myopathies
• Transverse myelitis
• Encephalitis affecting the brainstem
• Certain infections, e.g. polio and enterovirus
• Guillain-Barre syndrome
• Neuromuscular junction diseases, e.g. botulism

How is tetraparesis treated?

Before treating tetraparesis, the underlying cause must be identified and the extent of nerve damage assessed. After this, depending on the cause, various treatments may be possible:

• Surgical removal of spinal discs that are compressing nerves
• Surgery to resolve other causes of spinal cord compression
• Surgical tendon release
• Assistive devices to aid movement, such as walking sticks, wheelchairs, etc.
• Physical therapy to strengthen muscles while the nerves recover