PARAPLEGIA

Paralysis (paraplegia) or weakness (paraparesis) of both legs may result from spinal cord injury such as accidental fracture, decompression illness, muscle disease such as poliomyelitis or a brain injury such as cerebral palsy or stroke.

Fitness & Diving: Diving fitness depends on the cause and the extent of disability in each individual case.

Considerations include:

1. The extent of physical disability that may determine whether the candidate can perform the required water skills. High spinal cord injury (closer to the head) may compromise breathing. How? Respiratory signals come from the spinal cord at the c4-5 level, so a fracture at or above that level will likely paralyze the diaphragm. A fracture at the mid-thoracic (chest) level will paralyze the legs, while a fracture at c5-6 will cause severe paralysis of the arms as well.

2. Diving in itself does not cause further injury unless the diver gets decompression sickness involving the spinal cord. In that case, because the spinal cord is already damaged, there may be an increased risk of residual disability, even after prompt treatment.

3. There are reliable programs (e.g., associations of disabled divers) designed to accommodate diving candidates with such problems. These programs emphasize the importance of avoiding DCS by careful diving practices.

4. As with multiple sclerosis and other CNS considerations, deciding on whether to dive with paraplegia requires a case-by-case decision. Decide after consultation with your physician.

(Hugh Greer MD, Alert Diver, May-June 1999.)