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What Is Quadriparesis?

Medically Reviewed by Dan Brennan, MD on May 11, 2021

Quadriparesis is a condition in which you have muscle weakness in all four of your limbs (both legs and both arms). Also called tetraparesis, this weakness and diminished mobility can be temporary or permanent.

Unlike quadriplegia — which is a full paralysis or inability to move all four limbs — quadriparesis is characterized by overall weakness in your arms and legs, but you can still feel and move your limbs. 

Quadriparesis can be caused by illness or injury. If you have quadriparesis, your individual treatment and long-term outlook will depend on the underlying cause of your condition. 

What Are the Symptoms of Quadriparesis?

There are varying degrees of quadriparesis or tetraparesis, which include different levels of muscle weakness or loss of control.

Symptoms can include: 

  • Muscle limpness or lack of firmness. Also called flaccid paralysis, muscles in your limbs can be soft or lack strength, but will remain flexible or move easily.  
  • Muscle stiffness or tightness. Also known as spastic quadriplegia or spastic paralysis, your muscles can appear unusually stiff, tight, or unable to move freely. 
  • Loss of motor control. The inability to control the specific motions of your arms, legs, feet, or hands, this symptom is also known as ataxia.  
  • Difficulty walking. Because of the muscle weakness in the legs, walking may become challenging for individuals with quadriparesis.
  • Loss of bladder control. Due to the closeness of the legs to the pelvis, some loss of feeling may affect the bladder. 
  • Reflex depression. Because the nerves conducting messages from your muscles to brain are not fully functioning, the reflexes in your arms and legs may not be as strong or quick as they would typically be.

Quadriparesis is usually the symptom of an underlying illness or injury, and your specific symptoms can vary depending on the cause in your specific case. 

What Are the Causes of Quadriparesis?

Like quadriplegia, quadriparesis is caused by an interruption in the nerves that send signals between your body and your brain. These nerves travel through your spinal column. When the nerves are damaged or otherwise disturbed, the signals are disrupted. This can happen as a result of a condition that you're born with, an illness that affects the nerves, or an injury.

A condition you're born with. Some particular conditions, called congenital conditions, are ones that people are born already having. Some of these can cause quadriparesis or quadriplegia. They can include: 

  • Muscular dystrophy
  • Multiple sclerosis
  • Cerebral palsy

A disease or illness that you contract. There are some diseases that can have an impact on your spinal cord and the nerves that conduct messages to and from your brain. Some illnesses that can cause quadriparesis include:

  • Polio
  • Enterovirus
  • Lyme disease
  • Diphtheria
  • Dengue Fever
  • Epstein-Barr virus
  • West Nile virus

An injury that damages your spine. Any kind of trauma to your neck, head, or back can cause quadriparesis or quadriplegia if the nerves are subjected to enough damage. Car or motorcycle accidents, falls while riding a bike or horse, sports injuries like those sustained in football or hockey, a gunshot, or any kind of slip and fall can cause injury to your spinal nerves. 

Nutrient imbalance. Some kinds of imbalances of vitamins or nutrients in your body can cause quadriparesis. For example, hyperkalemia (too much potassium in your blood) can cause symptoms of quadriparesis. Fortunately, this kind of case can often be reversed fully and quickly. 

Most of the time, quadriparesis does not happen as a lone symptom. Because quadriparesis is usually a symptom of another underlying cause — illness or injury — there are often other symptoms that come along with it. These additional signs and symptoms can be helpful to your doctor when diagnosing quadriparesis.

How Is Quadriparesis Diagnosed?

Your doctor will want a full family history and your own background to try and discover the cause of your quadriparesis. For instance, your doctor will want to know if you have suffered any recent injuries or trauma, or if you have had recent surgery on your back or neck.

In order to fully assess the extent of the damage to your spine, and what might be done to improve your symptoms of quadriparesis, your doctor may order one or more nerve tests. These may include electromyography (EMG), which is a test that can assess muscle and nerve function or nerve conduction studies. 

Additionally, your doctor may perform blood tests to look for any deficiencies or infections in your blood, or a spinal tap or lumbar puncture, which is a procedure to examine your spinal fluid.

If necessary, your doctor might order biopsies of your muscles or nerves; this means they collect a small sample of the tissue to closely examine.

Treatment of Quadriparesis

The course of treatment for quadriparesis depends entirely on what is causing it. If your doctor determines that you have an infection or illness that can be treated or managed with medication, they may prescribe a specific treatment plan for you. For example, if your quadriparesis is caused by an inflammatory or autoimmune condition, specific drugs can help minimize your symptoms. 

If your symptoms have been caused by an injury to your spine, your doctor may consider surgery, pain medication, muscle relaxants, or therapy to help you regain your strength and dexterity. 

Outlook for Quadriparesis

Your specific diagnosis and the underlying cause of your quadriparesis or tetraparesis will influence your outlook. Some causes — like specific injuries or acquired illnesses — can be treated and your symptoms may be at least partially, if not fully reversible. 

However, other people with quadriparesis do not regain their mobility or strength in their limbs. Discuss your symptoms with your doctor to determine the underlying cause of quadriparesis and what treatment steps may be helpful in your case.

Even if your muscle weakness and diminished mobility are not able to be fully reversed, there are many resources to maximize your quality of life. Be sure to ask your medical provider about assistive technology, mobility aids, and therapies that may help. 

Show Sources

SOURCES:

ACP Hospitalist: "Functional quadriplegia."

American Academy of Allergy Asthma & Immunology: "Immunosuppressive Medication for the Treatment of Autoimmune Disease."

American Association of Neurological Surgeons: "Spinal Cord Injury."

Children's Hospital St. Louis: "Spastic Quadriplegia."

Christopher & Dana Reeve Foundation: "Causes of Paralysis."

Hospital for Special Surgery: "EMG Testing: A Patient's Guide."

Indian Journal of Critical Care Medicine: "Hyperkalemia: A Rare Cause of Acute Flaccid Quadriparesis."

Physical Medicine and Rehabilitation Clinics of North America: "Muscle Biopsy Evaluation in Neuromuscular Disorders."

Plos Medicine: "An Acute Evolving Flaccid Quadriparesis in an Elderly Woman."

Top Spinal Cord Injury Rehabilitation: "Causes of Spinal Cord Injury."

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