Spinal shock
From Wikipedia, the free encyclopedia
 |
This article may require cleanup to meet Wikipedia's quality standards. Please discuss this issue on the talk page or replace this tag with a more specific message. This article has been tagged since November 2006. |
Contents |
[edit] Spinal Cord Transection
Spinal cord transection can be divided into two types: 1. Complete Transection(spinal shock) 2. Hemitransection
[edit] Complete Transection (spinal shock)
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. Reflexes in the spinal cord caudal to the transection are depressed while those in the cranial part remain unaffected. The cause of spinal shock is uncertain but it is related to the sudden interruption of impulses from the higher parts of the nervous system.
Duration of the shock varies with the degree of encephalization of motor function. Lower animals regain the lost reflexes in minutes but in humans it takes a minimum of two weeks. The recovery may be attributed to newly formed collaterals from the existing nerves.
[edit] Findings Below the Level of the 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.
 |
This medical article is a stub. You can help Wikipedia by expanding it. |
After spinal cord injury, in the acute stage, a phenonmena called spinal shock occurs. In the acute stage, there will be hypotone paralysis, areflexia, loss of sensory function and dysautonomia. Patient shows retention of the bladder due to the imparied reflex of emptying the bladder.
[edit] Recovery
1. Smooth muscles recover first with return of defecation and micturation reflexes 2. Skeletal muscle reflexes return 3. Autonomic reflexes are last to return
In post acute stage, patient shows autonomic dysreflexia if the lesion level is above T6. In the chronic stage, there will be hypertone paralysis, hyper-reflexia, spastic-reflex bladde. Patient at this stage shows incontinence. But upon return of autonomic reflexes, the patient can now control micturation and defecation, sweating function returns and circulation improves.
