Making Sense of Spastic Quadriplegia


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Spastic quadriplegia – a form of cerebral palsy – is a devastating condition in which normal movement and motor function is severely disrupted in young children and newborns due to brain damage.

There are nine forms of cerebral palsy, three of which have been labeled as spastic – diplegia (affecting both sides of the body, usually the legs), hemiplegia (affecting one side of the body, often one arm and one leg), and quadriplegia (all four limbs and the torso are affected.)

These three types of spastic cerebral palsy account for 70 percent of all cases of the condition. Spastic refers to the muscle stiffness that’s usually associated with these three forms of CP.

What is Spastic Quadriplegia?

Spastic quadriplegia is a developmental disorder that can occur before birth, during delivery, or within the first few years of life. Motor function is severely hampered in the children affected, making everyday tasks and activities much more challenging.

Quad, in Latin, refers to all four quadrants of the body, in this case, the limbs. Plegia, also a Latin word, means paralysis. The torso is also usually affected, as is the face. And occasionally spastic quadriplegia is accompanied by other conditions like epilepsy and ADHD.

What are the Symptoms of Spastic Quadriplegia?

Signs and symptoms of spastic quadriplegia will be different for every child and depend on the severity of the brain damage. These are the most common symptoms to watch for:

  • Difficulty or inability to walk
  • Troubles with speech
  • Floppy neck due to lack of control
  • Severe stiffness in limbs
  • Seizures

Depending on the seriousness of the condition, and in particular the stiffness of the child’s limbs, symptoms can also include an abnormal gait, crossed knees, abnormal reflexes, walking on tip-toes, and joints that are unable to fully extend.

What are the Causes of Spastic Quadriplegia?

Spastic quadriplegia occurs due to damage to the motor cortex and/or pyramidal tracts of the brain, both of which affect movement.

The motor cortex is located in the largest part of the brain – the cerebral cortex – and is responsible for sending signals to other areas of the brain that also control movement. Any damage to this area results in voluntary movements that are difficult to control.

The pyramidal tracts are like the communication byways between the cerebral cortex and the spinal cord nerves. When damage occurs to this area, sending those important signals is disrupted, which also results in the hampering of sensory functions like sight and touch.

The direct causes of damage to these areas include:

  • Infections, both before and after birth
  • Prenatal brain hemorrhage
  • Lack of oxygen to the brain before and during birth
  • Brain trauma

Poor maternal health is also sometimes a contributing factor, as are the many individual causes that result in infection, lack of oxygen, and brain trauma.

Often, the underlying cause of spastic quadriplegia is medical malpractice, or errors on the part of doctors or other medical professionals.

What are the Treatment Options for Spastic Quadriplegia?

Sadly, there is no cure for spastic quadriplegia, which is why the goals of treatment are usually to A) make the patient as comfortable as possible, and B) to increase mobility.

Treatment will depend on a few different factors, including:

  • The severity of the symptoms
  • The location of the patient’s movement issues
  • Any corresponding conditions and complications

Physical Therapy

Physical therapy is usually the first course of treatment, as it helps to increase movement and independence for the child. The goal of therapy, beyond improving general motor function, is to help prevent future complications. To accomplish this, therapists will use range-of-motion exercises to stretch stiff muscles and improve joint mobility.

Therapists will often combine exercises with age-appropriate games and toys to make therapy as enjoyable as possible.

Occupational Therapy

The role of occupational therapy is to improve the patient’s ability to perform everyday tasks and activities that we associate with life at home, school, work, and public environments.

Occupational therapists will target specific muscles in the upper body, such as the wrists, thumbs, and forearms, which should help to improve motor control, coordination, and upper body strength. Occupational therapists will also assess the need for assisted devices that can enhance the performance of certain actions and activities.

Speech Therapy

The goal of speech therapy is mostly to improve the oral movements associated with speech. This is often done by helping to strengthen the muscles used to speak, which aids in improving articulation and coordination.

Common side effects of spastic quadriplegia include drooling, along with difficulty chewing, breathing, and swallowing, which are also areas that speech therapists will help to improve. In general, speech therapy should aid in helping children socialize and express themselves vocally.

If therapy alone isn’t enough to improve a patient’s quality of life, medications and/or surgery may also be considered. Specifically, medications that aid in relaxing stiff muscles are common, as are anti-seizure medications. Surgeries that improve sensory impairments and joint dislocations may also be recommended.

What Should You Do if Your Child has Spastic Quadriplegia?

Living with spastic quadriplegia presents untold challenges to both the children who suffer from it and their parents. And these challenges go way beyond those related to health, as the medical costs associated with this condition can be immense.

If you suspect that medical malpractice was the cause of your child’s spastic quadriplegia, it’s important to understand the recourse options available to you. You may be entitled to compensation through a medical malpractice lawsuit, but your time to file a claim is limited.

The experienced lawyers at Ross Feller Casey have an unmatched record of winning multi-million-dollar recoveries in all types of birth injury lawsuits, including those involving spastic quadriplegia. We have a team of Ivy League trained physicians, and doctors who are also lawyers, right on staff, making us uniquely qualified to litigate even the most complex birth injury cases. Contact the leading spastic quadriplegia lawyers at Ross Feller Casey now for a free case evaluation.

About the Author

With more than 20 years of experience as a physician, Dr. Gerald B. Parker brings a unique perspective as a Philadelphia doctor-lawyer to Ross Feller Casey.

Gerald Parker, III

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