Revisit Spinal Shock: Pattern of Reflex Evolution during Spinal Shock.
10.13004/kjnt.2018.14.2.47
- Author:
Hyun Yoon KO
1
Author Information
1. Department of Rehabilitation Medicine, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Rehabilitation Hospital, Pusan National University Yangsan Hospital, Yangsan, Korea. drkohy@gmail.com
- Publication Type:Review
- Keywords:
Automatism;
Reflex;
Spinal cord;
Spinal cord injuries
- MeSH:
Automatism;
Muscle Spasticity;
Reflex*;
Reflex, Stretch;
Shock*;
Spinal Cord;
Spinal Cord Injuries
- From:Korean Journal of Neurotrauma
2018;14(2):47-54
- CountryRepublic of Korea
- Language:English
-
Abstract:
When the spinal cord is suddenly severed, all the fundamental functions of the spinal cord below the level of injury including the spinal cord reflexes are immediately depressed, which is referred to as spinal shock. The resolution of spinal shock occurs over a period of days to months, and spinal shock slowly transitions to spasticity. The definition of spinal shock and the pattern of reflex recovery or evolution remains as an issue of debate and controversy. The identification of clinical signs that determine the duration of spinal shock is controversial. The underlying mechanisms of spinal shock are also not clearly defined. Various authors have defined the termination of spinal shock as the appearance of the bulbocavernosus reflex, the recovery of deep tendon reflexes, or the return of reflexic detrusor activity. However, many questions remain to be answered, such as: When should we define spinal shock as the end? What types of reflexes appear first among polysynaptic cutaneous reflexes, monosynaptic deep tendon reflexes, and pathological reflexes? Should it include changes in autonomic reflexes such as a detrusor reflex?
