• is associated with a complex array of symptoms and signs depending on the level and severity of the injury
• In general, significant spinal cord trauma results in initial loss of somatic and autonomic nerve function called spinal shock.
• spinal shock stage usually resolves in one to three weeks at which time, the injured individual moves into a heightened reflex activity stage where the spinal reflexes return resulting in a changing clinical picture.
• Spinal Shock Stage
Spinal shock is characterized by the following symptoms below the level of the lesion:
• Flaccid paralysis
• Loss of sensation
During this period the injured person also experiences:
• Loss of bladder and rectal control
• in addition to spinal shock, individuals with cervical or upper thoracic cord injury may experience neurogenic shock.
• In spinal cord injury, neurogenic shock is caused by the loss of sympathetic nervous system activity, which results in loss of vascular tone below the lesion level.
• When vascular tone is lost, massive vasodilation occurs, resulting in severe hypotension.
Heightened Reflex Activity Stage of Spinal Cord Trauma
• After spinal shock resolves, the individual moves into a heightened reflex activity stage, whereby upper motor neuron dysfunction presents with:
• Return of bladder-emptying reflex
• Hypertonic paralysis
autonomic hyperreflexia (dysreflexia)
• A troublesome manifestation that develops in this stage.
• This syndrome results from massive, uncompensated cardiovascular responses to sympathetic nervous system discharge, including hypertension, sweating, and flushing.
• It can be stimulated by pain, touch, or often a full bladder or bowel
• can be relieved with parasympathetic stimulation such as bowel- or bladder-emptying.