Spinal Shock
A state of absence of reflexes below the level of a spinal cord injury.
The prognosis for recovery from an injury severe enough to result in spinal shock is not good. The patient's blood pressure and fluids should be adequate to maintain good blood flow and oxygen delivery to his spinal cord. This will not bring dead (infarcted) spinal cord tissue back to life but may decrease damage to vulnerable tissue surrounding the site of injury that because of swelling and inflammation are more vulnerable to decreased blood supply.
Immediately following spinal cord injury there is a period where you have no
movement, no sensation, and no reflexes below the level of the lesion. It can
last for hours to weeks and then may get better.
The spinal cord functions mainly by relaying information back and forth between
the brain and different parts of the body. It also has a few reflex functions
such as control of “deep tendon reflexes” (what the doctor taps on during his
physical examination), control of sweating, control of blood vessel tone.
When the spinal cord is severely injured or partially severed, there is
paralysis and loss of sensation of the parts of the body below the level of the
injury. In spinal SHOCK there is also temporary
loss of the spinal reflex functions. This results in a loss of the ability
to sweat/perspire and loss of bladder and bowel control.
The extremities become limp. There is also loss of control of the tone in
blood vessels. The vessels become dilated and because of this, blood pressure
drops. The duration of spinal shock varies but usually begins to resolve
within 1 to 6 weeks. It is then followed by heightened spinal reflexes. The
limbs become “spastic” and stiff and the deep tendon reflexes become increased
(For instance, testing the deep tendon reflex in the knee normally causes the
lower leg to move, but in a patient with increased reflexes, tapping the knee
may cause the whole leg to move)
In spinal shock, there is usually no loss of consciousness unless the blood pressure drops very low from the blood vessel dilation. Patients who only have a spinal cord injury can think, talk and see normally; they just can’t control their body. Many times, though, people who injure their spinal cord in car accidents or diving accidents will also injure their head, as well. In these instances, there may be other problems and at the time of injury they may black out. I do not know of any blood tests which are altered by spinal shock. Results of alcohol and drug tests should, I believe, be valid.
Symptoms of Spinal shock
Course