Spinal cord injury results in the interruption of nerve signals between the brain and the periphery of the body. This leaves the patient with profound loss of various functions as well as psychological impairment. Specifically, the injury is called quadriplegia or tetraplegia if the injury occurs at the cervical spinal level. It is called paraplegia if the injury occurs at the thoracic, lumbar or sacral spinal levels. There are several behavioral characteristics of spinal cord injury.
Sensory and Motor
The most obvious and devastating change in behavior following spinal cord injury is the impairment or complete loss of sensory and motor functions. The severity of these impairments depends on the spinal level of injury as well as the degree of spinal cord tissue involvement. Sensory and motor impairment occurs below the level of injury, but function is preserved above that level.
Spasticity and Dysreflexia
When the patient is paralyzed, one effect is spasticity, or involuntary muscle contractions. Symptoms may range from mild stiffness to exaggerated movements and tendon reflexes. Autonomic dysreflexia is a serious consequence of higher level spinal cord injuries. It is an over activity of the autonomic nervous system and can result in high blood pressure, slowed heart rate, headache, nausea, sweating and other symptoms which require immediate attention.
Bladder and Bowel
Bladder and bowel dysfunction is affected by spinal cord injury at almost any spinal level. The bladder is generally affected in one of two ways after spinal cord injury. A spastic bladder is when the bladder empties reflexively. In contrast, a flaccid bladder is when the bladder muscles are weak or nonfunctional. Catheterization is a common way to achieve controlled bladder emptying. The bowel is affected by the level of the injury. With lesions above T-12 reflex defecation may be preserved, although the feeling of a full rectum may be lost. Below T-12 reflex defecation may be lost, and is called a flaccid bowel.
Depression
Clinical depression is a common illness affecting millions of people. Depression occurs in people with spinal cord injury at rates several fold that of the rest of the population. Physical and psychological symptoms of depression can include one or several of the following: sleepiness, feeling hopeless, lowered energy levels, changed appetite, loss of interest in people and activities, difficulty concentrating, feelings of worthlessness and thoughts of death or suicide.
Sexuality
Sexuality is often impaired after spinal cord injury. The degree of impairment depends on the level of injury as well as how much spinal cord tissue is damaged. For males, erectile dysfunction, and loss of orgasm and libido are common outcomes of spinal cord injury. For females, the expression of sexuality is usually not as profoundly affected by the injury as with men. Women's sexual dysfunction is more associated with their experience and interaction with their partner. The level of libido may be unaffected but the level of activity can be greatly diminished, presumably because women with disabilities have fewer sexual partners than men.
