I was watching an episode of Alaska State Troopers and there was a accident involving inner tube towed by a car. The patient presented with single sided lack of sensation in her left side I believe. She had total extremity sensation in the right. Is this possible? Can a spinal trauma cause "hemiplegia" ? If so how exactly does that work?
Interesting... There was no penetrating trauma and as I continue to watch the patient regained sensation a few hours later so that could be possible.. It seemed like it was just a temporary response from her nervous system saying "what the :censored::censored::censored::censored: did you just do to me!?!?!?" Then again I had a very limited observation as I was not there.
Transient spinal cord injury can cause temporary single sided sensation loss from 15 minutes to 48 hours. In most cases spinal stenosis is present and is a factor.
We talking both extremities on a side, or add the torso, or face or, what?
ROT (rule of thumb), find the most superior point of complaint of paraesthesia, follow that dermatome, and that gives you a starting point to suspect spinal insult.
HOWEVER, not common for a spinal chord insult to present as entire-sided paraesthesia, and Brown-Sequard seems to preclude spontaneous recovery: it refers to spinal chord partial transection "characterized by a motor deficit and numbness to touch and vibration on the same side of the spinal injury and loss of pain and temperature sensation on the opposite side".
Change in field treatment: none unless the innertuber's spontaneous recovery fits your protocols to "clear" them of spinal trauma. I'd be thinking about a closed head injury, or maybe they just took such a shot to one side that the extremities are numb from localized nerve whumping.
Need a MRI. Go to hospital. Forget about paying back student loans.
TSCI is somewhat common in athletes and other activities involving collision. It comes from the onset of a "Stinger or Burner". TSCI has been know to cause temporary paralyzation in one or more of the four quadrants and is often associated with Spinal Stenosis according to J Bone Joint Surg Am. 1986This injury is becoming more common as players become more aggressive in size and speed. It would definitely be something I would look at in the above mentioned case.
I know if you bang a nerve hard enough it will stop working for a spell, the spinal stenosis aspect will be interesting to read about. If I can't find a link I'll PM you.
They are considering a neuropraxia resulktig in transient quadriplegia and paraesthesia secondary to cervical spine compression of the cord, without localized pain (so you don't immediately suspect exactly where the insult occurred). Doesn't cover a lateral hemiplegia/paraesthesia.
Their description of numbness and burning pain sure correspond with what I experienced with a lateral C4-5 root stenosis, I do not wish that sort of pain on anyone, especially if it is the whole body!!!
The patient regaining sensation is normal, sometimes they get it all back, sometimes they just get reflexes. Inflammation is usually the culprit and often in the ICU when we get spinal cord trauma we start them on a methylprednisolone continuous infusion. It is a 48 hour protocol and hyperglycemia usually becomes an issue.
