800:(ADLs), such as getting dressed, eating, and bowel/bladder care. Individuals with C5 injuries retain some function in their biceps, deltoids, and other muscles; they typically can perform many ADLs including feeding, bathing, and grooming but require total assistance with bowel/bladder care. The C6 level adds function in the extensor carpi radialis, longus, and other muscles allowing for wrist extension, scapular abduction, and wrist flexion; typically, these patients have modified independent feeding and grooming with adaptive equipment, independent with dressing, can use both a manual and power wheelchair but require assistance with some activities of daily living. The C7 level is where function is retained in the triceps allowing for arm extension; C7 is considered the key level at which most activities can be performed independently with a wheelchair and assistive devices; activities include feeding, grooming, dressing, light meal preparation, and transfers on level surfaces. Even in complete spinal cord injury, it is common for individuals to recover up to 1 level of motor function.
631:(ASIA) classification. The ASIA scale grades patients based on their functional impairment as a result of the injury, grading a patient from A to D. This has considerable consequences for surgical planning and therapy. After a comprehensive neurologic exam testing segments of the body corresponding to spinal nerve roots, the examiner will determine the patient's motor level and sensory level (i.e. motor level C6, sensory level C7). These levels are unique for the patient's left and right side. This level is assigned based on the lowest (closest to the patient's feet) intact motor and sensory level. After this assignment, a neurological level of injury (NLI) is determined. The NLI is the lowest segment with intact sensory and motor function provided there is normal sensory and motor function above this segment.
40:
607:
886:"Tetraplegia", meaning the paralysis of four limbs, may be confused with "tetraparesis", meaning the weakness of four limbs. In medicine, it is important to not use these terms when making a diagnosis. When diagnosing and classifying spinal cord injuries, the ASIA classification is used to distinguish between weakness vs. no weakness, and to classify neurologically complete vs. incomplete lesions. Use of "tetraparesis" is discouraged as it inaccurately describes an incomplete lesion and incorrectly implies tetraplegia applies only to cases of complete lesions.
788:
422:(elbow flexion) will be spared; in this case, an injury at the C6 root level affects all function at that level and below whereas the C5 nerve root, which controls the biceps, is spared since it is above the C6 level in the spinal column. When classifying an individual's level of function, there are numerous functional assessment tools that may be used in a clinical setting and it is often up to the clinician's discretion as to which tools are used. A comprehensive list of these tools may be found on the
217:
tetraplegia is that the victim cannot move legs, arms, or any other major body regions; this is often not the case. Some tetraplegics can walk and use their hands, as though they did not have a spinal cord injury, while others may use wheelchairs and retain some functions in their arms and fingers; again, this varies based on the degree of damage to the spinal cord and is mostly seen with incomplete tetraplegia.
745:
be performed. In contrast, for patients with ASIA D (incomplete) tetraplegia it is difficult to assign an
International Classification other than International Classification level X (others). Therefore, it is more difficult to decide which surgical procedures should be performed. A far more personalized approach is needed for these patients. Decisions must be based more on experience than on texts or journals.
213:-dependent. An individual with a C7 injury may lose function from the chest down but still retain use of the arms and much of the hands. An individual in between, with a C5 injury may lose some function from the chest down and fine motor skills in his/her hands but still have flexion and extension abilities of certain muscles around the back or arm area.
740:: a lesion similar to cauda equina syndrome however this lesion is typically found higher in the cord. This presents clinically similarly to cauda equina syndrome however there may be intact sacral reflexes. Unlike cauda equina, the unique location of this syndrome leads it to present with mixed upper and lower motor neuron signs.
693:
sensation in the perineal area. S4 and S5 are both sacral nerve roots found at the lowest portion of the spinal cord. In simpler terms, "complete" is meant as a way to express that the spinal cord is injured such that no signal, motor or sensory, is carried to or from the level of injury to these lower levels of the spinal cord.
756:
Spasticity is a frequent consequence of incomplete injuries. Spasticity often decreases function, but sometimes a patient can control the spasticity in a way that it is useful to their function. The location and the effect of the spasticity should be analyzed carefully before treatment is planned. An
744:
For most patients with ASIA A (complete) tetraplegia, ASIA B (incomplete) tetraplegia and ASIA C (incomplete) tetraplegia, the
International Classification level of the patient can be established without great difficulty. The surgical procedures according to the International Classification level can
778:
Upper limb paralysis refers to the loss of function of the elbow and hand. When upper limb function is absent as a result of a spinal cord injury it is a major barrier to regain autonomy. People with tetraplegia should be examined and informed concerning the options for reconstructive surgery of the
752:
Patients with an incomplete lesion also often need therapy or surgery before the procedure to restore function to correct the consequences of the injury. These consequences are hypertonicity/spasticity, contractures, painful hyperesthesias and paralyzed proximal upper limb muscles with distal muscle
383:
Tetraplegia is defined in many ways; C1âC4 usually affects arm movement more so than a C5âC7 injury; however, all tetraplegics have or have had some kind of finger dysfunction. So, it is not uncommon to have a tetraplegic with fully functional arms but no nervous control of their fingers and thumbs.
842:
The estimated lifetime costs for a 25-year-old in 2018 is $ 3.6 million when affected by low tetraplegia and $ 4.9 million when affected by high tetraplegia. In 2009, it was estimated that the lifetime care of a 25-year-old rendered with low tetraplegia was about $ 1.7 million, and $
748:
The results of tendon transfers for patients with complete injuries are predictable. On the other hand, it is well known that muscles lacking normal excitation perform unreliably after surgical tendon transfers. Despite the unpredictable aspect in incomplete lesions, tendon transfers may be useful.
413:
can be determined. This informs the evaluator as to what activities may be limited as a result of the injury. This is typically done at 72 hours post-injury; exams done prior to this time have been found to be inaccurate due to the presence of swelling and other confounding factors. For example, an
692:
As in the above ASIA chart, a complete spinal cord injury is any injury which has absent motor and sensory function in the sacral segments S4 and S5. This is verified during the physical exam by the absence of all three of: voluntary anal contraction, deep anal pressure, and pinprick+light touch
396:
Since tetraplegia is defined as dysfunction in the cervical spinal cord, this section will focus on the anatomy of the cervical spinal cord. To understand how tetraplegia presents after injury, it is imperative to have a broad knowledge of the cervical spinal roots and its many functions. In the
224:
Another important factor is the possibility that the patient may exhibit sporadic movement in the affected areas. One of the main causes for this would be myoclonus, or muscle spasms. "After a spinal cord injury, the normal flow of signals is disrupted, and the message does not reach the brain.
795:
Delayed diagnosis of cervical spine injury has grave consequences for the victim. About one in 20 cervical fractures are missed and about two-thirds of these patients have further spinal-cord damage as a result. About 30% of cases of delayed diagnosis of cervical spine injury develop permanent
220:
It is common to have partial movement in limbs, such as the ability to move the arms but not the hands, or to be able to use the fingers but not to the same extent as before the injury. Furthermore, the deficit in the limbs may not be the same on both sides of the body; either side may be more
216:
The extent of the injury is also important. A complete severing of the spinal cord will result in complete loss of function from that vertebra down. A partial severing or even bruising of the spinal cord results in varying degrees of mixed function and paralysis. A common misconception with
726:: a lesion of the lumbosacral nerve roots that may spare the spinal cord. As these nerve roots are lower motor neurons, a flaccid lower limb paralysis is typically seen along with loss of bowel and bladder reflexes, varying degrees of impairment of sensation, and loss of sacral reflexes (
882:
for "four". In the past, "tetraplegia" and "quadriplegia" were used interchangeably in the medical literature. Medical literature favors using "tetraplegia" as the standardized term, as it is frowned upon to mix Greek and Latin roots, although "quadriplegia" remains in use.
208:
The severity of the condition depends on both the level at which the spinal cord is injured and the extent of the injury. An individual with an injury at C1 (the highest cervical vertebra, at the base of the skull) will probably lose function from the neck down and be
384:
It is possible to have a broken neck without becoming tetraplegic if the vertebrae are fractured or dislocated but the spinal cord is not damaged. Conversely, it is possible to injure the spinal cord without breaking the spine, for example when a ruptured
714:: hemisection of the spinal cord with resultant loss in: a.) ipsilateral proprioception, vibration, and motor control below the level of injury b.) complete sensory loss at the level of injury c.) contralateral pain and temperature loss.
821:
Tetraplegics can improve muscle strength by performing resistance training at least three times per week. Combining resistance training with proper nutrition intake can greatly reduce co-morbidities such as obesity and type 2 diabetes.
708:: an injury to the central area of the spinal cord, most often seen as a result of a fall with subsequent hyperextension injury. This typically presents with weakness greater in the upper limbs than in the lower limbs.
1829:
1814:
818:, which is caused by damage to the motor cortex either before, during (10%), or after birth, some people with incomplete tetraplegia are gradually able to learn to stand or walk through physical therapy.
720:: a lesion of the anterior two-thirds of the spinal cord, most commonly due to ischemia. This typically presents with loss of pain, temperature, and motor function at and below the level of injury.
749:
The surgeon should be confident that the muscle to be transferred has enough power and is under good voluntary control. Pre-operative assessment is more difficult to assess in incomplete lesions.
47:
Affected areas (pink) representing differences between paraplegia (left), hemiplegia (middle), and tetraplegia (right). Areas may differ for each condition and are dependent upon level of injury.
61:
836:
There are an estimated 17,700 spinal cord injuries each year in the United States; the total number of people affected by spinal cord injuries is estimated to be approximately 290,000 people.
796:
neurological deficits. In high-level cervical injuries, total paralysis from the neck can result. High-level tetraplegics (C4 and higher) will likely need constant care and assistance in
1782:
2172:
169:
Although the most obvious symptom is impairment of the limbs, functioning is also impaired in the trunk and pelvic organs. This can lead to loss or impairment of controlling
701:
Incomplete spinal cord injuries result in varied post injury presentations. There are three main syndromes described, depending on the exact site and extent of the lesion.
839:
In the US, spinal cord injuries alone cost approximately $ 40.5 billion each year, which is a 317 percent increase from costs estimated in 1998 ($ 9.7 billion).
225:
Instead, the signals are sent back to the motor cells in the spinal cord and cause a reflex muscle spasm. This can result in a twitch, jerk or stiffening of the muscle."
1166:
2919:
2083:
1556:
2165:
1684:"The SCIRehab project: treatment time spent in SCI rehabilitation. Physical therapy treatment time during inpatient spinal cord injury rehabilitation"
681:
Motor function is preserved below the neurological level; at least half of key muscles below the neurological level have a muscle grade of 3 or more.
670:
Motor function is preserved below the neurological level; more than half of key muscles below the neurological level have a muscle grade less than 3.
245:, causes the loss of partial or total function of all four limbs, meaning the arms and the legs. Typical causes of this damage are trauma (such as a
1787:
659:
Sensory but not motor function is preserved at S4âS5. No motor function is preserved >3 levels below the motor neurological level of injury.
1107:
2158:
157:. A loss of sensory function can present as an impairment or complete inability to sense light touch, pressure, heat, pinprick/pain, and
761:(Botox) into spastic muscles is a treatment to reduce spasticity. This can be used to prevent muscle shortening and early contractures.
2117:
1918:
1533:
1083:
181:
functions. Furthermore, sensation is usually impaired in affected areas. This may manifest as numbness, reduced sensation or
1563:
1514:
1359:
Hentz VR, Leclercq C (May 2008). "The management of the upper limb in incomplete lesions of the cervical spinal cord".
915:
764:
Over the last ten years, an increase in traumatic incomplete lesions is seen, due to the better protection in traffic.
628:
803:
Even with "complete" injuries, in some rare cases, through intensive rehabilitation, function can be regained through
773:
1725:
2018:
831:
579:
2768:
2053:
185:. Secondarily, because of their depressed functioning and immobility, tetraplegics are often more vulnerable to
1528:
375:
254:
1751:
846:
About 1,000 people are affected each year in the UK (~1 in 60,000âassuming a population of 60 million).
356:
1436:
2816:
1956:
1951:
1507:
920:
895:
161:. In these types of spinal cord injury, it is common to have a loss of both sensation and motor control.
1127:"Does sacral posterior rhizotomy suppress autonomic hyper-reflexia in patients with spinal cord injury?"
1111:
797:
345:
1242:
2668:
2663:
2099:
1911:
737:
2058:
711:
2150:
2129:
2003:
1844:
1755:
178:
2763:
2559:
2112:
2078:
2035:
1976:
1943:
503:
311:
2753:
2351:
2134:
2124:
2008:
1935:
727:
717:
1873:
1682:
Taylor-Schroeder S, LaBarbera J, McDowell S, Zanca JM, Natale A, Mumma S, et al. (2011).
2775:
2068:
2063:
2025:
963:"International Standards for Neurological Classification of Spinal Cord Injury: Revised 2019"
961:
Rupp R, Biering-SĂžrensen F, Burns SP, Graves DE, Guest J, Jones L, et al. (2021-03-01).
723:
705:
485:
297:
198:
39:
2232:
606:
2924:
2846:
2314:
2013:
1904:
624:
202:
174:
154:
423:
8:
2878:
2780:
2703:
2030:
1993:
1833:
804:
410:
385:
266:
250:
1167:"Spasticity and Spinal Cord Injury | Model Systems Knowledge Translation Center (MSKTC)"
2615:
2605:
2600:
2509:
2374:
2272:
2181:
2045:
1988:
1708:
1683:
1654:
1627:
1603:
1578:
1327:
1300:
1278:
1101:
1044:
987:
962:
910:
270:
258:
170:
138:
118:
2577:
1838:
1301:"Classifications In Brief: American Spinal Injury Association (ASIA) Impairment Scale"
1216:
2595:
2406:
2364:
2222:
2212:
2139:
1971:
1966:
1745:
1713:
1699:
1659:
1608:
1486:
1465:"Effects of resistance training on adiposity and metabolism after spinal cord injury"
1417:
1376:
1332:
1282:
1270:
1262:
1220:
1148:
1143:
1126:
1089:
1079:
1036:
992:
808:
329:
246:
150:
88:
52:
133:
leading to partial or total loss of function in the arms, legs, trunk, and pelvis. (
2731:
2610:
2569:
2257:
2199:
1983:
1703:
1695:
1649:
1639:
1598:
1590:
1476:
1407:
1368:
1322:
1312:
1254:
1212:
1138:
1048:
1026:
982:
974:
142:
1594:
2873:
2806:
2743:
2718:
2708:
2698:
2685:
2675:
2237:
1849:
1777:
1481:
1464:
758:
406:
333:
94:
1884:
149:
segments of the spinal cord and arm function is retained.) The paralysis may be
2863:
2826:
2391:
2379:
2267:
2252:
1557:"National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance"
1508:"National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance"
1412:
1395:
871:
815:
468:
315:
158:
1823:
1372:
1317:
1258:
1093:
2913:
2898:
2841:
2439:
2329:
2289:
2242:
2227:
1772:
1266:
520:
110:
2836:
2653:
2529:
2522:
2517:
2459:
2444:
2247:
2207:
2107:
1927:
1717:
1663:
1612:
1490:
1441:
1421:
1380:
1336:
1274:
1224:
1073:
1040:
996:
307:
190:
57:
1152:
1031:
1014:
2883:
2858:
2758:
2726:
2693:
2463:
2384:
2319:
2294:
2277:
1879:
1868:
401:(i.e. the C6 nerve root exits above the C6 vertebra). By evaluating what
238:
122:
80:
1644:
787:
648:
No motor or sensory function is preserved in the sacral segments S4âS5.
249:, diving into shallow water, a fall, a sports injury), disease (such as
2821:
2639:
2634:
2625:
2554:
2488:
2478:
2416:
2339:
2073:
1998:
978:
905:
900:
402:
341:
210:
194:
134:
1806:
1125:
Schurch B, Knapp PA, Jeanmonod D, Rodic B, Rossier AB (January 1998).
854:
The condition of paralysis affecting four limbs is alternately termed
221:
affected, depending on the location of the lesion on the spinal cord.
2893:
2853:
2831:
2811:
2785:
2748:
2736:
2644:
2587:
2564:
2493:
2483:
2473:
2454:
2424:
2396:
2369:
2304:
2284:
731:
182:
130:
2180:
1396:"Current concepts in reconstruction of hand function in tetraplegia"
2790:
2630:
2468:
2449:
1527:
398:
325:
293:
126:
1078:. Steven Kirshblum, Vernon W. Lin (3rd ed.). New York. 2019.
414:
injury at the C6 nerve root level will affect the function of the
2868:
2539:
415:
337:
186:
610:
Cervical spine illustration showing the vertebra and nerve roots
397:
cervical spine, nerve roots exit the spine above the associated
2888:
2549:
2434:
2429:
2401:
2359:
2217:
1818:
1791:
1203:
McDonald JW, Sadowsky C (February 2002). "Spinal-cord injury".
960:
597:
419:
388:
or bone spur on the vertebra protrudes into the spinal column.
242:
146:
1896:
366:
Transverse myelitis (from viral, bacterial, or fungal source)
2544:
2534:
1579:"Challenging questions regarding the international standards"
1247:
Physical
Medicine and Rehabilitation Clinics of North America
863:
262:
234:
114:
2324:
2185:
1626:
Nas K, Yazmalar L, Ćah V, Aydın A, ĂneĆ K (January 2015).
878:, for "paralysis". Tetraplegia uses the Greek root ÏΔÏÏα
1463:
Gorgey AS, Mather KJ, Cupp HR, Gater DR (January 2012).
1681:
1796:
637:
83:
or brain by illness or injury; congenital conditions
2084:
Spinal cord injury without radiographic abnormality
1625:
177:, sexual function, digestion, breathing and other
1576:
696:
627:are classified as complete and incomplete by the
241:at a high level. The injury, which is known as a
125:. A loss of motor function can present as either
2911:
1202:
1732:. n.d. Archived from the original on 5 Jan 2014
1393:
1198:
1196:
1194:
1192:
1190:
1188:
1186:
687:
405:of the cervical spine is injured, the affected
1502:
1500:
1299:Roberts TT, Leonard GR, Cepela DJ (May 2017).
1298:
1294:
1292:
1243:"Predicting Outcomes After Spinal Cord Injury"
1241:Chay, Wesley; Kirshblum, Steven (2020-08-01).
1124:
2166:
1912:
1730:Apparelyzed â Spinal Cord Injury Peer Support
1462:
1428:
1358:
1240:
2920:Cerebral palsy and other paralytic syndromes
1354:
1352:
1350:
1348:
1346:
1183:
1008:
1006:
956:
1549:
1497:
1469:Medicine and Science in Sports and Exercise
1456:
1387:
1289:
1118:
967:Topics in Spinal Cord Injury Rehabilitation
954:
952:
950:
948:
946:
944:
942:
940:
938:
936:
109:, is defined as the dysfunction or loss of
2173:
2159:
1919:
1905:
1577:Solinsky R, Kirshblum SC (November 2018).
1521:
1305:Clinical Orthopaedics and Related Research
1106:: CS1 maint: location missing publisher (
1012:
38:
1707:
1653:
1643:
1602:
1480:
1411:
1343:
1326:
1316:
1142:
1030:
1003:
986:
197:, respiratory complications, infections,
1781:) is being considered for deletion. See
1628:"Rehabilitation of spinal cord injuries"
1619:
1434:
933:
843:3.1 million with high tetraplegia.
786:
605:
450:Spinal Motor & Sensory Innervations
1724:
1534:Christopher & Dana Reeve Foundation
791:Christopher Reeve speaking at MIT, 2003
391:
233:Tetraplegia is caused by damage to the
2912:
1555:
1506:
62:physical medicine & rehabilitation
2154:
1900:
1015:"Spasticity after spinal cord injury"
431:Key Muscle Groups and Sensory Points
164:
16:Paralysis of all four limbs and torso
1236:
1234:
1159:
1068:
1066:
1064:
1062:
1060:
1058:
1688:The Journal of Spinal Cord Medicine
1583:The Journal of Spinal Cord Medicine
1564:University of Alabama at Birmingham
1515:University of Alabama at Birmingham
1013:Adams MM, Hicks AL (October 2005).
13:
2223:Festinating gait/Parkinsonian gait
1674:
916:Sexuality after spinal cord injury
629:American Spinal Injury Association
14:
2936:
1785:to help reach a consensus. âș
1764:
1231:
1055:
774:Upper-limb surgery in tetraplegia
619:
2817:Overpronation/Flexible flat feet
2019:Chronic traumatic encephalopathy
1700:10.1179/107902611X12971826988057
1144:10.1046/j.1464-410x.1998.00482.x
832:List of people with quadriplegia
2054:Anterior spinal artery syndrome
1926:
1570:
1400:Scandinavian Journal of Surgery
825:
292:Motor vehicle accident, falls,
1726:"Quadriplegia and Tetraplegia"
1394:Fridén J, Reinholdt C (2008).
849:
697:Incomplete spinal-cord lesions
424:ShirleyRyan AbilityLab website
205:, and cardiovascular disease.
193:and fractures, frozen joints,
1:
1770:
1595:10.1080/10790268.2017.1362929
1217:10.1016/S0140-6736(02)07603-1
926:
805:"rewiring" neural connections
357:Amyotrophic lateral sclerosis
2268:Myopathic gait/Waddling gait
1632:World Journal of Orthopedics
1482:10.1249/MSS.0b013e31822672aa
862:. Quadriplegia combines the
782:
779:tetraplegic arms and hands.
767:
688:Complete spinal-cord lesions
614:
7:
1957:Intraventricular hemorrhage
1952:Intraparenchymal hemorrhage
921:Spinal cord injury research
896:Clearing the cervical spine
889:
137:is similar but affects the
10:
2941:
1413:10.1177/145749690809700411
1131:British Journal of Urology
829:
807:, as in the case of actor
798:activities of daily living
771:
488:at the midclavicular line
418:(elbow extension) but the
2799:
2717:
2684:
2669:Lower motor neuron lesion
2664:Upper motor neuron lesion
2586:
2502:
2469:Myotonia / Pseudomyotonia
2415:
2350:
2192:
2184:relating to movement and
2130:Injury of accessory nerve
2098:
2044:
1934:
1859:
1800:
1750:: CS1 maint: unfit URL (
1373:10.1016/j.hcl.2008.01.003
1318:10.1007/s11999-016-5133-4
1259:10.1016/j.pmr.2020.03.003
738:Conus medullaris syndrome
636:
467:1 cm lateral to the
228:
87:
75:
67:
51:
46:
37:
29:
24:
2004:Post-concussion syndrome
1783:templates for discussion
2113:Peripheral nerve injury
2079:Posterior cord syndrome
2036:Penetrating head injury
1977:Subarachnoid hemorrhage
1944:Intracranial hemorrhage
1529:"Stats about paralysis"
870:, for "four", with the
504:acromioclavicular joint
376:GuillainâBarrĂ© syndrome
312:spinal muscular atrophy
255:GuillainâBarrĂ© syndrome
2135:Brachial plexus injury
2125:Wallerian degeneration
2059:Brown-SĂ©quard syndrome
2009:Second-impact syndrome
1936:Traumatic brain injury
792:
728:bulbocavernosus reflex
718:Anterior cord syndrome
712:Brown-SĂ©quard syndrome
611:
572:Small finger abductors
2776:Boutonniere deformity
2069:Central cord syndrome
2064:Cauda equina syndrome
2026:Diffuse axonal injury
1110:) CS1 maint: others (
1032:10.1038/sj.sc.3101757
790:
724:Cauda equina syndrome
706:Central cord syndrome
609:
564:Dorsal little finger
550:Dorsal middle finger
486:supraclavicular fossa
298:recreational activity
199:autonomic dysreflexia
2847:Clasp-knife response
2014:Dementia pugilistica
1075:Spinal cord medicine
625:Spinal cord injuries
392:Anatomy and function
374:Multiple sclerosis,
267:congenital disorders
203:deep vein thrombosis
71:Complete, incomplete
2879:Conversion disorder
2781:Swan neck deformity
2704:Locomotive syndrome
2031:Abusive head trauma
1994:Cerebral laceration
1754:) CS1 maint: year (
1645:10.5312/wjo.v6.i1.8
1435:Burkeman O (2002).
558:Long finger flexors
451:
432:
277:
251:transverse myelitis
93:Based on symptoms,
2616:Spastic paraplegia
2606:Spastic paraplegia
2601:Periodic paralysis
2510:Abnormal posturing
2375:Dysdiadochokinesia
2311:Asynchronous gait
2273:Trendelenburg gait
2233:Marche Ă petit pas
2182:Signs and symptoms
2046:Spinal cord injury
1989:Cerebral contusion
1860:External resources
1562:. Birmingham, AL:
1513:. Birmingham, AL:
979:10.46292/sci2702-1
911:Locked-in syndrome
793:
612:
449:
430:
276:
271:muscular dystrophy
259:multiple sclerosis
165:Signs and symptoms
2907:
2906:
2596:Flaccid paralysis
2417:Abnormal movement
2407:Hemimotor neglect
2365:Cerebellar ataxia
2315:Gunslinger's gait
2213:Cerebellar ataxia
2148:
2147:
2140:Traumatic neuroma
2100:Peripheral nerves
1972:Epidural hematoma
1967:Subdural hematoma
1894:
1893:
1367:(2): 175â84, vi.
1211:(9304): 417â425.
1085:978-0-8261-3775-3
809:Christopher Reeve
685:
684:
603:
602:
521:antecubital fossa
448:
381:
380:
330:aortic dissection
328:due to arterial (
247:traffic collision
100:
99:
89:Diagnostic method
19:Medical condition
2932:
2611:Spastic diplegia
2578:Tonic immobility
2570:Waxy flexibility
2514:Stooped posture
2320:Hemiparetic gait
2301:Asymmetric gait
2200:Gait abnormality
2175:
2168:
2161:
2152:
2151:
1984:Brain herniation
1921:
1914:
1907:
1898:
1897:
1798:
1797:
1759:
1749:
1741:
1739:
1737:
1721:
1711:
1668:
1667:
1657:
1647:
1623:
1617:
1616:
1606:
1574:
1568:
1567:
1561:
1553:
1547:
1546:
1544:
1542:
1525:
1519:
1518:
1512:
1504:
1495:
1494:
1484:
1460:
1454:
1453:
1451:
1449:
1432:
1426:
1425:
1415:
1391:
1385:
1384:
1356:
1341:
1340:
1330:
1320:
1311:(5): 1499â1504.
1296:
1287:
1286:
1238:
1229:
1228:
1200:
1181:
1180:
1178:
1177:
1163:
1157:
1156:
1146:
1122:
1116:
1115:
1105:
1097:
1070:
1053:
1052:
1034:
1010:
1001:
1000:
990:
958:
634:
633:
452:
433:
429:
344:), or combined (
278:
275:
183:neuropathic pain
117:function in the
105:, also known as
42:
22:
21:
2940:
2939:
2935:
2934:
2933:
2931:
2930:
2929:
2910:
2909:
2908:
2903:
2874:Motion sickness
2807:Rachitic rosary
2795:
2744:Joint stiffness
2719:Range of motion
2713:
2680:
2676:Sleep paralysis
2660:General causes
2582:
2498:
2411:
2346:
2258:Vestibular gait
2238:Propulsive gait
2188:
2179:
2149:
2144:
2094:
2040:
1930:
1925:
1895:
1890:
1889:
1855:
1854:
1809:
1786:
1767:
1762:
1743:
1742:
1735:
1733:
1677:
1675:Further reading
1672:
1671:
1624:
1620:
1575:
1571:
1559:
1554:
1550:
1540:
1538:
1526:
1522:
1510:
1505:
1498:
1461:
1457:
1447:
1445:
1433:
1429:
1392:
1388:
1357:
1344:
1297:
1290:
1239:
1232:
1201:
1184:
1175:
1173:
1165:
1164:
1160:
1123:
1119:
1099:
1098:
1086:
1072:
1071:
1056:
1025:(10): 577â586.
1011:
1004:
959:
934:
929:
892:
852:
834:
828:
814:In the case of
785:
776:
770:
759:botulinum toxin
699:
690:
622:
617:
604:
544:Elbow extensors
530:Wrist extensors
394:
346:AV malformation
334:atherosclerosis
231:
167:
95:medical imaging
20:
17:
12:
11:
5:
2938:
2928:
2927:
2922:
2905:
2904:
2902:
2901:
2896:
2891:
2886:
2881:
2876:
2871:
2866:
2864:Astasia-abasia
2861:
2856:
2851:
2850:
2849:
2839:
2834:
2829:
2827:Bow-leggedness
2824:
2819:
2814:
2809:
2803:
2801:
2797:
2796:
2794:
2793:
2788:
2783:
2778:
2773:
2772:
2771:
2766:
2761:
2751:
2746:
2741:
2740:
2739:
2734:
2723:
2721:
2715:
2714:
2712:
2711:
2706:
2701:
2696:
2690:
2688:
2682:
2681:
2679:
2678:
2673:
2672:
2671:
2666:
2658:
2657:
2656:
2647:
2642:
2637:
2628:
2620:
2619:
2618:
2613:
2603:
2598:
2592:
2590:
2584:
2583:
2581:
2580:
2575:
2572:
2567:
2562:
2557:
2552:
2547:
2542:
2537:
2532:
2527:
2526:
2525:
2520:
2512:
2506:
2504:
2500:
2499:
2497:
2496:
2491:
2486:
2481:
2476:
2471:
2466:
2457:
2452:
2447:
2442:
2437:
2432:
2427:
2421:
2419:
2413:
2412:
2410:
2409:
2404:
2399:
2394:
2392:Sensory ataxia
2389:
2388:
2387:
2382:
2380:Pronator drift
2377:
2372:
2362:
2356:
2354:
2348:
2347:
2345:
2344:
2343:
2342:
2334:
2333:
2332:
2327:
2322:
2317:
2309:
2308:
2307:
2299:
2298:
2297:
2292:
2282:
2281:
2280:
2275:
2270:
2262:
2261:
2260:
2255:
2253:Truncal ataxia
2250:
2245:
2240:
2235:
2230:
2225:
2220:
2215:
2210:
2202:
2196:
2194:
2190:
2189:
2178:
2177:
2170:
2163:
2155:
2146:
2145:
2143:
2142:
2137:
2132:
2127:
2122:
2121:
2120:
2118:classification
2115:
2104:
2102:
2096:
2095:
2093:
2092:
2091:(Quadriplegia)
2086:
2081:
2076:
2071:
2066:
2061:
2056:
2050:
2048:
2042:
2041:
2039:
2038:
2033:
2028:
2023:
2022:
2021:
2016:
2011:
2006:
1996:
1991:
1986:
1981:
1980:
1979:
1974:
1969:
1961:
1960:
1959:
1954:
1946:
1940:
1938:
1932:
1931:
1924:
1923:
1916:
1909:
1901:
1892:
1891:
1888:
1887:
1876:
1864:
1863:
1861:
1857:
1856:
1853:
1852:
1841:
1826:
1810:
1805:
1804:
1802:
1801:Classification
1795:
1794:
1766:
1765:External links
1763:
1761:
1760:
1722:
1678:
1676:
1673:
1670:
1669:
1618:
1589:(6): 684â690.
1569:
1548:
1520:
1496:
1455:
1437:"Man of steel"
1427:
1386:
1342:
1288:
1253:(3): 331â343.
1230:
1182:
1158:
1117:
1084:
1054:
1002:
931:
930:
928:
925:
924:
923:
918:
913:
908:
903:
898:
891:
888:
851:
848:
827:
824:
816:cerebral palsy
784:
781:
769:
766:
742:
741:
735:
721:
715:
709:
698:
695:
689:
686:
683:
682:
679:
676:
672:
671:
668:
665:
661:
660:
657:
654:
650:
649:
646:
643:
639:
638:
621:
620:Classification
618:
616:
613:
601:
600:
594:
591:
588:
584:
583:
576:
573:
570:
566:
565:
562:
559:
556:
552:
551:
548:
545:
542:
538:
537:
534:
531:
528:
524:
523:
517:
514:
511:
507:
506:
500:
497:
494:
490:
489:
483:
480:
477:
473:
472:
462:
459:
456:
447:
446:
445:Sensory Point
443:
440:
437:
428:
393:
390:
379:
378:
372:
371:Demyelinating
368:
367:
364:
360:
359:
354:
350:
349:
323:
319:
318:
316:cerebral palsy
305:
301:
300:
290:
286:
285:
282:
230:
227:
187:pressure sores
166:
163:
159:proprioception
98:
97:
91:
85:
84:
77:
73:
72:
69:
65:
64:
55:
49:
48:
44:
43:
35:
34:
31:
27:
26:
18:
15:
9:
6:
4:
3:
2:
2937:
2926:
2923:
2921:
2918:
2917:
2915:
2900:
2899:Dancing mania
2897:
2895:
2892:
2890:
2887:
2885:
2882:
2880:
2877:
2875:
2872:
2870:
2867:
2865:
2862:
2860:
2857:
2855:
2852:
2848:
2845:
2844:
2843:
2842:Hyperreflexia
2840:
2838:
2835:
2833:
2830:
2828:
2825:
2823:
2820:
2818:
2815:
2813:
2810:
2808:
2805:
2804:
2802:
2798:
2792:
2789:
2787:
2784:
2782:
2779:
2777:
2774:
2770:
2767:
2765:
2762:
2760:
2757:
2756:
2755:
2754:Hypermobility
2752:
2750:
2747:
2745:
2742:
2738:
2735:
2733:
2730:
2729:
2728:
2725:
2724:
2722:
2720:
2716:
2710:
2707:
2705:
2702:
2700:
2697:
2695:
2692:
2691:
2689:
2687:
2683:
2677:
2674:
2670:
2667:
2665:
2662:
2661:
2659:
2655:
2651:
2648:
2646:
2643:
2641:
2638:
2636:
2632:
2629:
2627:
2624:
2623:
2621:
2617:
2614:
2612:
2609:
2608:
2607:
2604:
2602:
2599:
2597:
2594:
2593:
2591:
2589:
2585:
2579:
2576:
2573:
2571:
2568:
2566:
2563:
2561:
2560:Joint locking
2558:
2556:
2553:
2551:
2548:
2546:
2543:
2541:
2538:
2536:
2533:
2531:
2528:
2524:
2521:
2519:
2516:
2515:
2513:
2511:
2508:
2507:
2505:
2501:
2495:
2492:
2490:
2487:
2485:
2482:
2480:
2477:
2475:
2472:
2470:
2467:
2465:
2461:
2458:
2456:
2453:
2451:
2448:
2446:
2443:
2441:
2440:Fasciculation
2438:
2436:
2433:
2431:
2428:
2426:
2423:
2422:
2420:
2418:
2414:
2408:
2405:
2403:
2400:
2398:
2395:
2393:
2390:
2386:
2383:
2381:
2378:
2376:
2373:
2371:
2368:
2367:
2366:
2363:
2361:
2358:
2357:
2355:
2353:
2349:
2341:
2338:
2337:
2335:
2331:
2330:Antalgic gait
2328:
2326:
2323:
2321:
2318:
2316:
2313:
2312:
2310:
2306:
2303:
2302:
2300:
2296:
2293:
2291:
2290:Steppage gait
2288:
2287:
2286:
2283:
2279:
2276:
2274:
2271:
2269:
2266:
2265:
2263:
2259:
2256:
2254:
2251:
2249:
2246:
2244:
2243:Stomping gait
2241:
2239:
2236:
2234:
2231:
2229:
2228:Magnetic gait
2226:
2224:
2221:
2219:
2216:
2214:
2211:
2209:
2206:
2205:
2203:
2201:
2198:
2197:
2195:
2191:
2187:
2183:
2176:
2171:
2169:
2164:
2162:
2157:
2156:
2153:
2141:
2138:
2136:
2133:
2131:
2128:
2126:
2123:
2119:
2116:
2114:
2111:
2110:
2109:
2106:
2105:
2103:
2101:
2097:
2090:
2087:
2085:
2082:
2080:
2077:
2075:
2072:
2070:
2067:
2065:
2062:
2060:
2057:
2055:
2052:
2051:
2049:
2047:
2043:
2037:
2034:
2032:
2029:
2027:
2024:
2020:
2017:
2015:
2012:
2010:
2007:
2005:
2002:
2001:
2000:
1997:
1995:
1992:
1990:
1987:
1985:
1982:
1978:
1975:
1973:
1970:
1968:
1965:
1964:
1962:
1958:
1955:
1953:
1950:
1949:
1947:
1945:
1942:
1941:
1939:
1937:
1933:
1929:
1922:
1917:
1915:
1910:
1908:
1903:
1902:
1899:
1886:
1882:
1881:
1877:
1875:
1871:
1870:
1866:
1865:
1862:
1858:
1851:
1847:
1846:
1842:
1840:
1836:
1835:
1831:
1827:
1825:
1821:
1820:
1816:
1812:
1811:
1808:
1803:
1799:
1793:
1789:
1784:
1780:
1779:
1774:
1769:
1768:
1757:
1753:
1747:
1731:
1727:
1723:
1719:
1715:
1710:
1705:
1701:
1697:
1694:(2): 149â61.
1693:
1689:
1685:
1680:
1679:
1665:
1661:
1656:
1651:
1646:
1641:
1637:
1633:
1629:
1622:
1614:
1610:
1605:
1600:
1596:
1592:
1588:
1584:
1580:
1573:
1565:
1558:
1552:
1536:
1535:
1530:
1524:
1516:
1509:
1503:
1501:
1492:
1488:
1483:
1478:
1475:(1): 165â74.
1474:
1470:
1466:
1459:
1444:
1443:
1438:
1431:
1423:
1419:
1414:
1409:
1405:
1401:
1397:
1390:
1382:
1378:
1374:
1370:
1366:
1362:
1355:
1353:
1351:
1349:
1347:
1338:
1334:
1329:
1324:
1319:
1314:
1310:
1306:
1302:
1295:
1293:
1284:
1280:
1276:
1272:
1268:
1264:
1260:
1256:
1252:
1248:
1244:
1237:
1235:
1226:
1222:
1218:
1214:
1210:
1206:
1199:
1197:
1195:
1193:
1191:
1189:
1187:
1172:
1168:
1162:
1154:
1150:
1145:
1140:
1136:
1132:
1128:
1121:
1113:
1109:
1103:
1095:
1091:
1087:
1081:
1077:
1076:
1069:
1067:
1065:
1063:
1061:
1059:
1050:
1046:
1042:
1038:
1033:
1028:
1024:
1020:
1016:
1009:
1007:
998:
994:
989:
984:
980:
976:
972:
968:
964:
957:
955:
953:
951:
949:
947:
945:
943:
941:
939:
937:
932:
922:
919:
917:
914:
912:
909:
907:
904:
902:
899:
897:
894:
893:
887:
884:
881:
877:
873:
869:
865:
861:
857:
847:
844:
840:
837:
833:
823:
819:
817:
812:
810:
806:
801:
799:
789:
780:
775:
765:
762:
760:
757:injection of
754:
750:
746:
739:
736:
733:
729:
725:
722:
719:
716:
713:
710:
707:
704:
703:
702:
694:
680:
677:
674:
673:
669:
666:
663:
662:
658:
655:
652:
651:
647:
644:
641:
640:
635:
632:
630:
626:
608:
599:
595:
592:
589:
586:
585:
582:of the elbow
581:
577:
574:
571:
568:
567:
563:
560:
557:
554:
553:
549:
546:
543:
540:
539:
536:Dorsal thumb
535:
532:
529:
526:
525:
522:
518:
515:
513:Elbow flexors
512:
509:
508:
505:
501:
498:
495:
492:
491:
487:
484:
481:
478:
475:
474:
470:
466:
463:
460:
457:
454:
453:
444:
441:
438:
435:
434:
427:
425:
421:
417:
412:
408:
407:muscle groups
404:
400:
389:
387:
377:
373:
370:
369:
365:
362:
361:
358:
355:
353:Degenerative
352:
351:
347:
343:
339:
335:
331:
327:
324:
321:
320:
317:
313:
309:
306:
303:
302:
299:
295:
291:
288:
287:
283:
280:
279:
274:
272:
268:
264:
260:
256:
252:
248:
244:
240:
236:
226:
222:
218:
214:
212:
206:
204:
200:
196:
192:
188:
184:
180:
176:
172:
162:
160:
156:
152:
148:
144:
140:
136:
132:
128:
124:
120:
116:
112:
108:
104:
96:
92:
90:
86:
82:
78:
74:
70:
66:
63:
59:
56:
54:
50:
45:
41:
36:
32:
28:
23:
2837:Hyporeflexia
2732:Bethlem sign
2699:Gowers' sign
2654:Quadruplegia
2649:
2530:Opisthotonus
2523:Osteoporosis
2518:Camptocormia
2460:Hyperkinesia
2445:Fibrillation
2352:Coordination
2305:Leaping gait
2248:Spastic gait
2218:Choreic gait
2208:Scissor gait
2108:Nerve injury
2088:
1963:Extra-axial
1948:Intra-axial
1878:
1867:
1843:
1828:
1813:
1776:
1734:. Retrieved
1729:
1691:
1687:
1635:
1631:
1621:
1586:
1582:
1572:
1551:
1539:. Retrieved
1532:
1523:
1472:
1468:
1458:
1446:. Retrieved
1442:The Guardian
1440:
1430:
1406:(4): 341â6.
1403:
1399:
1389:
1364:
1361:Hand Clinics
1360:
1308:
1304:
1250:
1246:
1208:
1204:
1174:. Retrieved
1170:
1161:
1137:(1): 73â82.
1134:
1130:
1120:
1074:
1022:
1018:
970:
966:
885:
879:
875:
874:root Ïληγία
867:
860:quadriplegia
859:
855:
853:
845:
841:
838:
835:
826:Epidemiology
820:
813:
802:
794:
777:
763:
755:
751:
747:
743:
700:
691:
623:
596:Apex of the
464:
439:Muscle Group
395:
382:
308:Spina bifida
232:
223:
219:
215:
207:
191:osteoporosis
168:
121:area of the
107:quadriplegia
106:
102:
101:
58:Neurosurgery
33:Quadriplegia
2925:Neurotrauma
2884:Shell shock
2859:Hypnic jerk
2759:Gorlin sign
2727:Contracture
2694:Hemiparesis
2650:Tetraplegia
2464:Hypokinesia
2385:Dyssynergia
2295:Toe walking
2278:Pigeon gait
2089:Tetraplegia
1928:Neurotrauma
1880:GeneReviews
1869:MedlinePlus
1788:Tetraplegia
1771:âč The
1736:4 September
1638:(1): 8â16.
1541:4 September
1448:4 September
1019:Spinal Cord
973:(2): 1â22.
856:tetraplegia
850:Terminology
363:Infectious
340:), venous (
304:Congenital
284:Conditions
239:spinal cord
123:spinal cord
103:Tetraplegia
81:spinal cord
30:Other names
25:Tetraplegia
2914:Categories
2822:Knock-knee
2640:Hemiplegia
2635:Paraplegia
2626:Monoplegia
2622:Syndromes
2555:Hypertonia
2489:Echopraxia
2479:Stereotypy
2340:Lotus gait
2336:Deformity
2074:Paraplegia
1999:Concussion
1176:2022-10-03
1094:1079055185
927:References
906:Paraplegia
901:Hemiplegia
830:See also:
772:See also:
678:Incomplete
667:Incomplete
656:Incomplete
580:epicondyle
411:dermatomes
403:nerve root
342:thrombosis
211:ventilator
195:spasticity
135:Paraplegia
79:Damage to
2894:Catatonia
2854:Shivering
2832:Back knee
2812:Flat feet
2786:Scoliosis
2749:Ankylosis
2737:Club foot
2645:Triplegia
2588:Paralysis
2574:Grimacing
2565:Catalepsy
2503:Posturing
2494:Echolalia
2484:Akathisia
2474:Hypotonia
2455:Myoclonus
2425:Athetosis
2397:Asterixis
2370:Dysmetria
2285:Foot drop
2264:Muscular
1885:NBK344254
1283:219735858
1267:1047-9651
1171:msktc.org
1102:cite book
783:Prognosis
768:Treatment
753:sparing.
732:anal wink
615:Diagnosis
502:Over the
469:occipital
348:) causes
322:Vascular
269:(such as
179:autonomic
131:paralysis
53:Specialty
2791:Kyphosis
2686:Weakness
2631:Diplegia
2450:Myokymia
1773:template
1746:cite web
1718:21675354
1664:25621206
1613:28820352
1491:21659900
1422:19211389
1381:18456124
1337:27815685
1275:32624098
1225:11844532
1041:15838527
997:34108832
890:See also
645:Complete
519:Lateral
471:condyle
399:vertebra
326:Ischemia
294:violence
139:thoracic
127:weakness
119:cervical
2869:Vertigo
2540:Trismus
1850:D011782
1775:below (
1709:3066500
1655:4303793
1604:6217465
1566:. 2009.
1517:. 2018.
1328:5384910
1153:9467480
1049:2659838
988:8152171
578:Medial
416:triceps
338:embolus
289:Trauma
237:or the
175:bladder
155:spastic
151:flaccid
115:sensory
113:and/or
2889:Stupor
2709:Ptosis
2550:Tetany
2435:Tremor
2430:Chorea
2402:Abasia
2360:Ataxia
1874:001066
1792:Curlie
1778:Curlie
1716:
1706:
1662:
1652:
1611:
1601:
1537:. 2016
1489:
1420:
1379:
1335:
1325:
1281:
1273:
1265:
1223:
1205:Lancet
1151:
1092:
1082:
1047:
1039:
995:
985:
876:plegia
868:quadra
598:axilla
420:biceps
281:Cause
265:), or
243:lesion
229:Causes
147:sacral
145:, and
143:lumbar
76:Causes
2800:Other
2545:Cramp
2535:Spasm
1839:344.0
1824:G82.5
1560:(PDF)
1511:(PDF)
1279:S2CID
1045:S2CID
880:tetra
872:Greek
866:root
864:Latin
263:polio
261:, or
235:brain
171:bowel
111:motor
68:Types
2325:Limp
2204:CNS
2193:Gait
2186:gait
1845:MeSH
1834:9-CM
1756:link
1752:link
1738:2018
1714:PMID
1660:PMID
1609:PMID
1543:2018
1487:PMID
1450:2018
1418:PMID
1377:PMID
1333:PMID
1271:PMID
1263:ISSN
1221:PMID
1149:PMID
1112:link
1108:link
1090:OCLC
1080:ISBN
1037:PMID
993:PMID
465:>
442:Root
436:Root
409:and
386:disc
173:and
2769:HSD
2764:EDS
1830:ICD
1815:ICD
1790:at
1704:PMC
1696:doi
1650:PMC
1640:doi
1599:PMC
1591:doi
1477:doi
1408:doi
1369:doi
1323:PMC
1313:doi
1309:475
1255:doi
1213:doi
1209:359
1139:doi
1027:doi
983:PMC
975:doi
858:or
273:).
153:or
129:or
2916::
2652:/
2633:/
2462:/
1883::
1872::
1848::
1837::
1822::
1819:10
1748:}}
1744:{{
1728:.
1712:.
1702:.
1692:34
1690:.
1686:.
1658:.
1648:.
1634:.
1630:.
1607:.
1597:.
1587:41
1585:.
1581:.
1531:.
1499:^
1485:.
1473:44
1471:.
1467:.
1439:.
1416:.
1404:97
1402:.
1398:.
1375:.
1365:24
1363:.
1345:^
1331:.
1321:.
1307:.
1303:.
1291:^
1277:.
1269:.
1261:.
1251:31
1249:.
1245:.
1233:^
1219:.
1207:.
1185:^
1169:.
1147:.
1135:81
1133:.
1129:.
1104:}}
1100:{{
1088:.
1057:^
1043:.
1035:.
1023:43
1021:.
1017:.
1005:^
991:.
981:.
971:27
969:.
965:.
935:^
811:.
734:).
730:,
675:D
664:C
653:B
642:A
593:T2
587:T2
575:T1
569:T1
561:C8
555:C8
547:C7
541:C7
533:C6
527:C6
516:C5
510:C5
499:C4
493:C4
482:C3
476:C3
461:C2
455:C2
336:,
332:,
314:,
310:,
296:,
257:,
253:,
201:,
189:,
141:,
60:,
2174:e
2167:t
2160:v
1920:e
1913:t
1906:v
1832:-
1817:-
1807:D
1758:)
1740:.
1720:.
1698::
1666:.
1642::
1636:6
1615:.
1593::
1545:.
1493:.
1479::
1452:.
1424:.
1410::
1383:.
1371::
1339:.
1315::
1285:.
1257::
1227:.
1215::
1179:.
1155:.
1141::
1114:)
1096:.
1051:.
1029::
999:.
977::
590:-
496:-
479:-
458:-
426:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
