Spinal shock: Difference between revisions
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==Background== | ==Background== | ||
*Do not confuse with [[Neurogenic Shock]] | *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 | **Flaccid [[weakness|paralysis]], [[numbness|anesthesia]], absent bowel/[[urinary incontinence|bladder control]] and reflex activity, [[priapism]] | ||
**Can make an incomplete lesion appear as complete | **Can make an incomplete lesion appear as complete | ||
***Cord lesions cannot be deemed complete until spinal shock has resolved | ***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 | *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 | *Usually lasts day to weeks | ||
**Resolves when soft tissue swelling improves | **Resolves when soft tissue swelling improves | ||
* | |||
==Differential Diagnosis== | |||
{{Shock DDX}} | |||
==Evaluation== | |||
==Management== | |||
==Disposition== | |||
*Admission | |||
==See Also== | ==See Also== | ||
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*[[Neurogenic Shock]] | *[[Neurogenic Shock]] | ||
== | ==External Links== | ||
==References== | |||
<references/> | |||
[[Category:Trauma]] | [[Category:Trauma]] | ||
[[Category: | [[Category:Neurology]] | ||
Latest revision as of 20:39, 29 April 2020
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
- Distributive
- Hypovolemic
- Severe dehydration
- Hemorrhagic shock (traumatic and non-traumatic)
Evaluation
Management
Disposition
- Admission