Paraparesis or incomplete paraplegia? How should we call it?

The neurological examination terminologies and definitions of the status of spinal cord injured (SCI) patients are of great importance to establish scales and provide standard nomenclatures. There is a disagreement between the classical neurological terminology and the definitions of complete and incomplete paraplegia that have been proposed in traumatic spinal cord injured patients.

To discuss the adequacy and the impact of the terms incomplete paraplegia and paraparesis in current literature.

A review of the origin of the terms, definitions and nomenclatures applied by the most widespread assessment scales in traumatic SCI published in peer review papers was performed, searching the scales cited on the references of the latest American Spinal Injury Association classification (2002; available in http://www.asia-spinalinjury.org/ ) up to the first classification, described by Frankel et al. [14].

The term "incomplete paraplegia" has been used to define clinical situations classically described as "paraparesis".

The terms "complete" and "incomplete" are adequately used to characterize the completeness of spinal cord lesion but inadequately used when associated to the term "plegia" as a qualifier. Therefore, patients with any preservation of motor strength below the injury level should be described as paraparetic and not as incomplete paraplegic.