What is spinal shock
Reading File
Finding Sources
Searching PubMed
"spinal shock"
Searching the Web
spinal shock definition reflexes acute spinal cord injury Merck Manual
Spinal shock is a temporary phase immediately after an acute spinal cord injury in which neurologic activity below the level of injury is markedly suppressed.
Typical findings below the lesion are:
- Flaccid paralysis and reduced muscle tone
- Absent deep-tendon and cutaneous reflexes, including the anal wink and bulbocavernosus reflex
- Loss of sensation
- Bladder and bowel atony, often causing urinary retention
It is caused by sudden interruption of descending signals from the brain that normally facilitate spinal reflex circuits. It commonly resolves over days, though it can persist longer. Return of the bulbocavernosus reflex is a classic sign that spinal shock is ending; reflexes then return and may become exaggerated, with spasticity and Babinski signs.
Do not confuse it with neurogenic shock. Spinal shock is neurologic loss of reflex, motor, sensory, and autonomic function below the injury. Neurogenic shock is a circulatory problem, typically hypotension with bradycardia from loss of sympathetic tone after high spinal cord injury. Merck’s spinal-trauma reference distinguishes the two.
Difference with neurological shock
Reading File
Finding Sources
Searching PubMed
"spinal shock" AND "neurogenic shock"
Searching the Web
spinal shock versus neurogenic shock clinical differences spinal cord injury
“Neurological shock” usually means neurogenic shock.
| Feature | Spinal shock | Neurogenic shock |
|---|---|---|
| Main problem | Temporary loss of spinal cord function below injury | Loss of sympathetic vascular control |
| System affected | Neurologic | Cardiovascular/autonomic |
| Typical findings | Flaccid paralysis, absent reflexes, loss of sensation, urinary retention | Hypotension, bradycardia, warm dry skin, sometimes hypothermia |
| Mechanism | Sudden interruption of descending input to spinal reflex circuits | Loss of sympathetic tone, often with unopposed vagal activity |
| Injury level | Can occur after acute SCI at different levels | Most typical in cervical or upper thoracic SCI, especially above T6 |
| Duration | Days to weeks, ending as reflexes return | Usually acute and resolves with stabilization, but varies |
| Key clinical point | Makes early assessment of “complete” cord injury unreliable | A potentially life-threatening form of distributive shock requiring circulatory support |
They can occur together after a high spinal cord injury.
Easy memory aid:
- Spinal shock = reflexes and motor/sensory function are “off.”
- Neurogenic shock = blood pressure and heart-rate control are “off.”
In trauma, do not automatically attribute low blood pressure to neurogenic shock. Bleeding must be excluded first. NCBI overview and Merck spinal-trauma guidance describe this distinction.
This is a shared conversation. Sign in to Orris to start your own chat.