Following a traumatic spinal cord injury at the C5 level, 24 hours later there are no reflexes, sensation, or voluntary motor activity below the injury. This pattern indicates:

Following a traumatic spinal cord injury at the C5 level, 24 hours later there are no reflexes, sensation, or voluntary motor activity below the injury. This pattern indicates:

• A. Spasticity
• B. Decerebrate rigidity
• C. Spinal shock
• D. A lower motor neuron lesion

Answer: (A)

Immediately after a traumatic spinal cord injury, a temporary state called spinal shock can occur, marked by loss of reflexes, sensation, and voluntary movement below the level of injury. At 24 hours post-injury, it’s common to see no reflexes and flaccid paralysis below the lesion because the spinal cord’s neurons are momentarily unable to transmit signals. This phase can last days to weeks. As spinal shock resolves, reflexes begin to return and may become exaggerated, leading to spasticity with increased muscle tone and hyperreflexia. The pattern described fits spinal shock rather than spasticity, because spasticity is a later development after the initial shock subsides. Decerebrate rigidity would point to brainstem involvement, and a lower motor neuron lesion would typically present with immediate flaccidity and reduced reflexes at and below the lesion, not a transient absence followed by later hypertonia.

Immediately after a traumatic spinal cord injury, a temporary state called spinal shock can occur, marked by loss of reflexes, sensation, and voluntary movement below the level of injury. At 24 hours post-injury, it’s common to see no reflexes and flaccid paralysis below the lesion because the spinal cord’s neurons are momentarily unable to transmit signals. This phase can last days to weeks. As spinal shock resolves, reflexes begin to return and may become exaggerated, leading to spasticity with increased muscle tone and hyperreflexia. The pattern described fits spinal shock rather than spasticity, because spasticity is a later development after the initial shock subsides. Decerebrate rigidity would point to brainstem involvement, and a lower motor neuron lesion would typically present with immediate flaccidity and reduced reflexes at and below the lesion, not a transient absence followed by later hypertonia.