Neurogenic shock occurs when communication between the brain and body fails, causing blood vessels to lose tone and dilate. This expansion disrupts blood circulation and causes a dangerous drop in blood pressure.
This condition is most commonly seen after spinal cord injuries from traumatic events like car accidents or falls. However, it can also stem from specific brain disorders or complications.
If you suspect neurogenic shock, you must go to the emergency room or call 911 immediately. Prompt treatment is vital, as this condition is life-threatening and can cause permanent damage or death.
Main symptoms
The primary symptoms of neurogenic shock include:
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Rapid decrease in blood pressure and heart rate
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Excessive sweating
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Dizziness, fainting, and loss of consciousness
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Decrease in body temperature to below 96°F
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Bluish discoloration of the nails and lips
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Rapid, shallow breathing
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Reduced or absent urine output
The severity of symptoms typically correlates with the injury that caused the shock. In cases of spinal trauma, injuries higher up on the spine often result in more severe symptoms.
Other conditions, such as septic shock or cardiogenic shock, can present with similar symptoms. Regardless of the type, it is crucial to get to a hospital as quickly as possible to begin treatment.
Confirming a diagnosis
Doctors diagnose neurogenic shock through exclusion, specifically in people who have suffered trauma. This means a physician can only confirm the diagnosis after ruling out other conditions that produce the same symptoms.
To do this, the doctor will perform a physical exam, check vital signs, and run blood tests and imaging scans. These imaging tests often include a computed tomography (CT) scan or magnetic resonance imaging (MRI).
Possible causes
The leading cause of neurogenic shock is spinal cord injury resulting from significant trauma, such as a hard blow to the back or a traffic accident. Additionally, certain medical conditions like transverse myelitis and Guillain-Barré syndrome can trigger this type of shock.
Other potential causes include improper technique during the administration of epidural anesthesia. The use of certain drugs or medications that impact the nervous system may also lead to neurogenic shock.
Treatment options
Treatment for neurogenic shock must begin immediately to prevent serious, life-threatening complications. Therapy often starts in the emergency room and continues in the intensive care unit (ICU) for constant monitoring of vital signs.
Some forms of treatment include:
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Immobilization: Used in cases of spinal injury to prevent movement from worsening the damage
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Intravenous (IV) fluids: Helps increase fluid volume in the body to regulate blood pressure
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Atropine administration: A medication used to increase heart rate if the heart function is compromised
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Vasopressors (epinephrine, norepinephrine, phenylephrine, or ephedrine): Used alongside fluids to help stabilize blood pressure
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Corticosteroids, such as methylprednisolone: Administered to help reduce complications from neurological injuries
If an accident caused the shock, surgery might also be necessary to repair the physical injuries.
The treatment duration can range from one week to several months, depending on the injury type and severity. Once vital signs stabilize and the patient recovers from shock, physical therapy is usually required to regain muscle strength or adapt to daily activities.