Spinal shock: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
|||
| Line 6: | Line 6: | ||
***Cord lesions cannot be deemed complete until spinal shock has resolved | ***Cord lesions cannot be deemed complete until spinal shock has resolved | ||
*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 | **Mediated by S2-S4 | ||
*Usually lasts day to weeks | *Usually lasts day to weeks | ||
Revision as of 19:10, 20 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
- 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
- Can think of it as a "concussion" of the spinal cord
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)