Acute flaccid complete paralysis with areflexia and loss of perianal reflexes, below the level of spinal cord injury is due to -
Ans. is 'a' i.e., Spinal shock Spinal shock* Spinal shock refers to the period after spinal cord injury (usually 24-48 hours) when the reflex activity of the entirespinal cord becomes depressed. Spinal shock' occurs when the spinal cord fails temporarily following injury. During this period the reflex arcs below the level of spinal cord injury are notfunctioning. Spinal shock is basically flaccid paralysis with loss of all spinal reflexes. There is loss ofautonomic, reflex, motor and sensory activity below the level of the cord lesion.* Signs of spinal shock include:i) Flaccid paralysisii) Loss of deep tendon and perianal reflexes* The return of reflex activity below the level of a spinal cord injury signifies the end of spinal shock.* An accurate assessment of neurological status cannot be completed until spinal shock resolves. The earliest indicator of resolution is the return of bulbocavernous reflex. The significance of spinal shock lies in thedetermination of whether a patient has sustained a complete Vs incomplete spinal cord injury. This cannot be* determined until spinal shock has ended. If there is total absence of sensory or motor function below the level ofinjury, after spinal shock has resolved, It indicates complete cord injury. If there is some residual functiondistal to the level of injury after resolution of spinal shock indicates incomplete cord injury.* High thoracic cord has poor prognosis as this area has narrow spinal canal and precarious blood supply, watershadearea of blood supply lies in upper thoracic region.
Spinal shock
Denervation
Malingering
UMN paralysis
Spinal Injuries