Spinal shock

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Spinal shock is an initial period of “hypotonia” that can result from damage to the motor cortex or other brain regions concerned with the activation of motor neurons. This is the phenomena surrounding transection of the spinal cord that leads to temporary loss or depression of all or most spinal reflex activity below the level of a spinal lesion. Since many of the descending motor nerves cross the midline, spinal shock originating from damage on one side of the brain (such as damage due to a stroke) can often be detected as reduced muscle activity on the contralateral side of the body. Loss of muscle function tends to be most severe in the arms and legs. Some control of trunk muscles is often preserved because of remaining brainstem pathways and spinal circuits that control midline musculature. Following the period of spinal shock, which can last from hours to 6 weeks, as long as the lower motor neurons are still intact, now a period of hyperreflexia sets in along with an increase in muscle tone. Also, now abnormal reflexes, e.g. the Babinski sign can be revealed. Early treatment is corticosteroids, methylprednisolone. Causes an imbalance between the sympathetic and parasympathetic nervous system. Assess for Babinski Reflex, if positive it means there is a neurological deficit.