How does 'spinal shock' present clinically?

Spinal shock is a clinical condition that occurs immediately after a spinal cord injury, characterized by a temporary loss of motor, sensory, and autonomic functions below the level of the injury. This state is marked by flaccid paralysis, where the affected muscles cannot contract voluntarily, leading to a lack of muscle tone. Additionally, there is a loss of reflexes below the level of the injury due to the disruption in neural pathways that normally facilitate these reflexes.

This flaccidity and lack of reflexes are primarily due to the sudden cessation of normal spinal cord function resulting from the injury. During spinal shock, the affected areas do not show any signs of reflexive response initially because the neural connections that mediate those responses have been temporarily impaired. This condition can last from a few days to several weeks.

In contrast to other potential presentations of spinal cord injuries, such as increased reflexes and spasticity in upper motor neuron lesions, spinal shock specifically denotes the absence of these functions right after the injury. Therefore, recognizing flaccid paralysis and loss of reflexes is essential for diagnosing spinal shock correctly.