paraplegia /per′əplē″jē·ə/ [Gk, para + plege, stroke] , paralysis characterized by motor or sensory loss in the lower limbs and trunk. Approximately 11,000 spinal cord injuries reported each year in the United States involve paraplegia. Such injuries commonly result from automobile and motorcycle accidents, sporting accidents, falls, and gunshot wounds. Paraplegia less commonly results from nontraumatic lesions, such as scoliosis, spina bifida, or neoplasms. Compare hemiplegia, quadriplegia. −paraplegic, adj., n. ▪ OBSERVATIONS: The signs and symptoms of paraplegia may develop immediately from trauma and include the loss of sensation, motion, and reflexes below the level of the lesion. Depending on the level of the lesion and whether damage to the spinal cord is complete or incomplete, the patient may lose bladder and bowel control, and sexual dysfunctions may develop. An incomplete spinal cord injury does not usually inhibit circumanal sensation, voluntary toe flexion, or sphincter control. A complete spinal cord injury destroys sensation and voluntary muscle control and usually causes the permanent loss of muscle function distal to the injury. ▪ INTERVENTIONS: The treatment of paraplegia seeks to restore proper spine alignment, stabilize the injured spinal area, decompress any involved neurological structures, and rehabilitate the patient as quickly as possible. At the accident scene when spinal cord injury is suspected, the patient must not be moved until strapped and stabilized on a board. Such stabilization helps to prevent permanent damage to any injured spinal structures. Drugs such as baclofen may be administered to relieve any muscle spasms associated with dysfunction of the upper motor neurons. ▪ PATIENT CARE CONSIDERATIONS: When the paraplegic patient progresses from bed rest to use of a wheelchair, the nurse is alert to any signs of orthostatic hypotension. Special binders and antiembolism hose are used to help the patient adjust to the transition from bed to wheelchair. Prevention of pressure sores is an important priority. Other treatment may include a high-bulk diet and the administration of suppositories to prevent constipation.
