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26 - Nontraumatic Spinal Cord Emergencies

from SECTION III - SPECIFIC NEUROLOGICAL CONDITIONS

Published online by Cambridge University Press:  06 August 2009

Michael G. Millin
Affiliation:
Oregon Health Sciences University Portland, Oregon
Sid M. Shah
Affiliation:
Assistant Clinical Professor Michigan State University
David G. Wright
Affiliation:
Department of Neurology Pittsburgh, Pennsylvania
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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Summary

Nontraumatic spinal emergencies can be caused by a wide spectrum of conditions including infection, hemorrhage, and neoplasm. The most common findings in patients with spinal emergencies are pain, motor deficits, sensory deficits, abnormal reflexes, and urinary dysfunction. Acute back pain is the only symptom of catastrophic spinal emergencies such as spinal hemorrhage or infection. Sudden paralysis can result from trauma, cord infarction, or hemorrhage. Even though a thorough sensory examination in the emergency department is often difficult and unreliable, complexes of sensory and motor abnormalities are helpful. As a result of the anatomical distribution of upper and lower motor neurons, acute spinal cord lesions almost always present with hyperreflexia. The mechanism of urinary incontinence depends on the type of lesion. Spinal cord emergencies frequently go unrecognized initially or are misdiagnosed even with such obvious symptoms as the inability to walk or bladder function failure.
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
, pp. 263 - 272
Publisher: Cambridge University Press
Print publication year: 2003

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References

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