SPINAL SHOCK

SPINAL SHOCK

How to identify for sure if it's a spinal shock? Know the various stages of spinal shock here.

Spinal Shock – The spine is a delicate part of the human body. It is very essential for the proper functioning of the nervous system. 

How would you ever know what to do if it wasn’t for the spine that connects the brain with the entire human body? That’s right! It wouldn’t.

Spinal cord injury is a well known concept even amongst the non-medical folks. The name says enough for itself. What is unknown to the people is the threats it poses. There are various repercussions of a spinal injury that renders a man incapable of functioning properly. Even if they are temporary, they can turn the world upside-down. One such problem worth learning about is a spinal shock

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WHAT IS SPINAL SHOCK? WHAT CAUSES A SPINAL SHOCK?

Spinal shock is a syndrome that involves a temporary or permanent loss of sensation and reflex below the level of injury on the spinal cord. It is not exactly a ‘shock’ in the circulatory collapse, but more of a state of depressed spinal reflexes.

Spinal shock is actually a combination of several neurological concerns  and reflexes that include autonomic dysfunction and hyporeflexia or as in some cases areflexia. 

Unlike the injury that happens spontaneously, spinal shock syndrome, generally, progresses over the hours.

The severity of the spinal shock is directly proportional to the severity of the injury. 

A point worth mentioning – Spinal shocks hold a lot of similarity with neurogenic shocks. The cause for both the syndromes is the same.


SPINAL SHOCK VS NEUROGENIC SHOCK:
 

The two syndromes are distinct on the basis of the differences between their respective effects on the body. 

While spinal shock involves the disruption of the connection between peripheral neurons and brain stimuli causing loss of sensation and reflexes, neurogenic shock is more about the disruption of the autonomic pathways.

In simple terms, neurogenic shock vs spinal shocks can be differentiated as the one that affects the entire nervous system versus the one that affects only the spinal cord and its functions.

Generally, the occurrence of neurogenic shock is limited to the cervical spinal cord (above T6).


THE STAGES OF SPINAL SHOCK

Spinal shock is divided in 4 stages depending on the days after the injury:

  • Zero to two days:
    Phase 1:  The patient may experience areflexia or hyporeflexia. It involves partial or complete loss of reflexes and muscle flaccidity.
  • One to three days:
    Phase 2: This stage involves returning or certain reflexes. In the elderly as well as children, DTR may remain absent. 
  • One to four weeks:
    Phase 3: This stage involves the reappearance of DTR in the body. Hyperreflexia occurs. 
  • One to twelve months:
    Phase 4: This stage, known as the final stage of hyperreflexia, is the longest in terms of duration. Neuron cells undergo changes.


WHAT ARE THE SYMPTOMS?

Spinal shock has a variety of symptoms in the body. These symptoms appear as the shock progresses which means at different stages of the syndrome, different symptoms are visible.The symptoms may differ from person to person.

  1. Low heart rate
  2. Increased blood pressure
  3. Flaccid paralysis
  4. Irregularities in the response from vasomotor
  5. Skin becomes pale
  6. Increased perspiration
  7. Urine retention
  8. Bowel inconsistency
  9. Weak genital reflexes


SPINAL SHOCK MANAGEMENT – WHAT IS THE TREATMENT FOR SPINAL SHOCK?

It can be deciphered that spinal shock is a symptom of spinal injury. It can not be termed as a disease but a compilation rising due to the injury. 

Things to know:

  1. Spinal shock can never be fatal. It is the injury that can be the underlying reason behind the death of the patient.
  2. Spinal shock patients are always treated in the Intensive Care Unit (ICU)
  3. The chances of complete and immediate recovery are low even while receiving the treatment. Improvement is only visible over a considerable period of time.
  4. To know the history of the patient is a necessity  for the treatment. What activities was the patient involved in, the medical condition , other issues, all need to be addressed before commencing the treatment. This will also help in forecasting the improvements in the reflexes.

Treatments:

  1. The use of steroids like Methylprednisolone. This treatment is a little controversial due to the side effects it may cause in the body. 
    It however is advised that if the patient is young and does not have any other medical complications, a small dosage of 30 mg can be given followed by a 5mg maintenance dosage for 24 hours. 
  2. Exercises for maintaining an appropriate body weight and strengthening the muscles. Ayurveda suggests various yoga poses that are believed to have benefited many.

     

  3. Other medications like pain killers, antibiotics etc., offered by allopathy, ayurveda as well as homeopathy.

     

  4. Using wheelchairs and other modern technologies for assisting body movement.

     

  5. Therapies – Both physical as well as occupational.
     
  6. Counselling lessons for a better mental state while coping  with the injury. 

60% of the patients show improvement following the surgery for the spinal injury. While rest is necessary, a satisfactory amount of movement through exercise can help speed up the process. However, exertion on the spinal cord should be avoided at all costs. 

CONCLUSION

It helps a lot to realize that unlike many conditions or disorders or diseases that can be fatal, spinal shock is a curable condition. 

Although, given that it is not something that happens spontaneously, or the fact that it might go unnoticed in several circumstances, one needs to understand its concept so as to be sure in situations where one might experience it.

Basic medications and self care is all that the body demands. Follow them strictly, and you are good to go!

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