Quadriparesis is a condition characterized by weakness in all four limbs (both arms and both legs). It’s also referred to as tetraparesis. The weakness may be temporary or permanent.
Quadriparesis is different from quadriplegia. In quadriparesis, a person still has some ability to move and feel their limbs. In quadriplegia, a person has completely lost the ability to move their limbs.
Quadriparesis can be caused by:
- an infection, like polio
- a neuromuscular disease, like muscular dystrophy
- damage to the nervous system due to an injury or another medical condition
If you have quadriparesis, your treatment plan and outlook will depend on the underlying cause.
Quadriparesis vs. quadriplegia
Quadriparesis and quadriplegia are both conditions characterized by loss of function in all four limbs. The main difference is in how much function is lost.
A person with quadriparesis experiences weakness and a partial loss of function of the limbs. A person with quadriplegia experiences paralysis, or total loss of sensation and control of their limbs.
What are the symptoms?
The symptoms of quadriparesis vary from person to person depending on which nerves are affected.
The main symptom of quadriparesis is weakness in all four limbs. A person with quadriparesis will have difficulty controlling the muscles in the affected body parts. They may be able to move one limb more than another.
Other symptoms may include:
- limp muscles that lack firmness (flaccid quadriparesis)
- unusual stiffness or tightness of the muscles (spastic quadriplegia)
- lack of motor control
- inability to walk
- loss of bladder control
- depressed reflexes
Quadriparesis is typically considered a symptom of another condition. Other symptoms will depend on the underlying cause of your quadriparesis.
Quadriparesis occurs when the nerves that send signals from your brain along the spine to muscles in your limbs are disturbed.
There are many reasons why this can happen. Some people are born with a condition that affects their nervous system. Others develop quadriparesis due to an accident or another medical condition that damages the nerves or spinal cord.
Viruses and bacteria can attack nerve tissues or cause inflammation in the body that results in damage to the nerves.
Examples of infections that can cause quadriparesis include:
- Lyme disease
- dengue fever
- hepatitis C
- Epstein-Barr virus
- West Nile virus
Nerve damage can also occur as a result of a toxin or poison, or as a side effect to certain medications. Examples include:
- alcohol poisoning or chronic alcohol abuse
- heavy metal poisoning
- snake venom
- scorpion sting
- tick paralysis
- certain chemotherapy treatments
Some people are born with a condition that affects their muscles and causes quadriparesis, such as:
Other medical conditions
Quadriparesis can also be a complication of another underlying medical condition, including:
- Guillain-Barré syndrome
- locked-in syndrome
- myasthenia gravis
- Lambert-Eaton syndrome
- paraneoplastic syndromes of the nervous system
- diabetic ketoacidosis
- electrolyte disturbances, like hyperkalemia (high potassium), hypokalemia (low potassium), and hypophosphatemia (low phosphate)
- vasculitic neuropathy
Injury/trauma to the spine
Quadriparesis may occur after an injury or trauma damages the spinal cord. Such damage can occur from:
- car accidents
- gun shooting
- slips and falls
- sports injuries
- slipped or herniated disk
- surgery of the spine
How it’s diagnosed
A doctor can diagnose quadriparesis by reviewing your symptoms and performing a physical exam. Your doctor will need to find out what’s causing your quadriparesis in order to know how to treat it properly.
You may be referred to a neuromuscular specialist for further testing. The specialist will review your medical and family health history and evaluate all of your symptoms. They may also conduct tests to assess your muscle or nerve function. These tests may include:
- MRI scan of the brain and spine, to see if you have a tumor or herniated disk
- electromyography (EMG), a nerve function test that reads electrical activity from the muscles (EMG can help your doctor differentiate between can muscle and nerve disorders.)
- nerve conduction studies to see how well your nerves and muscles respond to small electrical pulses
- lumbar puncture (spinal tap) to collect and analyze your cerebrospinal fluid (CSF)
- muscle or nerve biopsies, when a small sample of muscle or nerve is removed for further testing in a laboratory
- blood tests to look for vitamin deficiencies, diabetes, and electrolyte imbalances
Your treatment plan for quadriparesis depends on the underlying cause. For example, autoimmune or inflammatory conditions may be treated with immunosuppressive drugs. An electrolyte imbalance can be treated with medications that reverse the imbalance.
Other treatments may include:
- muscle relaxants
- pain medications
- physical therapy
- occupational therapy
- resistance training
Your doctor may recommend a variety of mobility aids (like a wheelchair or scooter) or other assistive devices to help you manage your symptoms.
What’s the outlook?
The overall outlook will depend on your underlying condition or the extent of your injury.
It’s possible for quadriparesis to be reversed in certain circumstances. For example, quadriparesis caused by hyperkalemia is often rapidly with treatment. Quadriparesis caused by a slipped disk may be reversed after surgery. Other people with quadriparesis may never regain mobility and strength in the limbs.
Ask your doctor for more information about your specific diagnosis and long-term outlook. If your quadriparesis is considered permanent, ask about mobility aids, assistive technology, and lifestyle changes that can help improve your quality of life.