Following trauma at the C5 spinal cord level, 24 hours later the patient shows no reflexes, sensation, or voluntary motor activity below the level of injury. These findings indicate which condition?

Following trauma at the C5 spinal cord level, 24 hours later the patient shows no reflexes, sensation, or voluntary motor activity below the level of injury. These findings indicate which condition?

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

Answer: (A)

Spinal shock is the concept at play here. After a traumatic injury to the spinal cord, there’s an acute period when all reflex activity, as well as motor and sensory function below the level of injury, is temporarily suppressed. At about 24 hours, it’s common to see no reflexes and flaccid paralysis below the lesion because the spinal circuits are briefly silenced. This is not a permanent loss from a peripheral nerve or motor neuron problem; it’s a transient state that often improves as reflexes return over days to weeks. When reflexes come back, tone may become spastic due to the return of upper motor neuron influence. Spasticity and decerebrate rigidity describe later UMN signs or brainstem involvement, not the immediate post-injury picture. So the presentation fits spinal shock.

Spinal shock is the concept at play here. After a traumatic injury to the spinal cord, there’s an acute period when all reflex activity, as well as motor and sensory function below the level of injury, is temporarily suppressed. At about 24 hours, it’s common to see no reflexes and flaccid paralysis below the lesion because the spinal circuits are briefly silenced. This is not a permanent loss from a peripheral nerve or motor neuron problem; it’s a transient state that often improves as reflexes return over days to weeks. When reflexes come back, tone may become spastic due to the return of upper motor neuron influence. Spasticity and decerebrate rigidity describe later UMN signs or brainstem involvement, not the immediate post-injury picture. So the presentation fits spinal shock.