Spinal shock
Background
- Do not confuse with Neurogenic Shock
- Transient stunning of the cord with global loss of function (unlike neurogenic shock) with temporary loss of spinal cord function below complete or incomplete spinal cord injury
- Flaccid paralysis, anesthesia, absent bowel/bladder control and reflex activity, priapism
- Can make an incomplete lesion appear as complete
- Cord lesions cannot be deemed complete until spinal shock has resolved
- Can think of it as a "concussion" of the spinal cord
Clinical Features
- Bulbocavernosus reflex is among the first to return as spinal shock resolves
- Performed by squeezing glans of penis or clitoris and monitoring for anus contraction
- Mediated by S2-S4
- Usually lasts day to weeks
- Resolves when soft tissue swelling improves
Differential Diagnosis
Shock
- Cardiogenic
- Acute valvular Regurgitation/VSD
- CHF
- Dysrhythmia
- ACS
- Myocardial Contusion
- Myocarditis
- Drug toxicity (e.g. beta blocker, CCB, or bupropion OD)
- Obstructive
- Air embolism
- Aortic Stenosis
- Cardiac Tamponade
- PE
- Tension pneumothorax
- Distributive
- Hypovolemic
- Severe dehydration
- Hemorrhagic shock (traumatic and non-traumatic)
Evaluation
Management
Disposition
- Admission
See Also
- Spinal Cord Trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
References
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