Spinal Cord Disease

Abstract

A 17-year-old boy fell from a horse while riding at about 40 miles an hour approximately 1–2 hours ago. He hit the ground head first with associated neck flexion. He complained of inability to move his arms or legs and some difficulty breathing. On examination, temperature was 37.2°C, BP 75/40 mmHg, HR was 48 per minute with RR at 30 per minute. Neurological examination showed intact mental status and cranial nerve function. Motor examination showed flaccid quadriplegia apart from MRC 1/5 strength in shoulder abduction and elbow flexion bilaterally. Sensory examination revealed a sensory level to pinprick at the level of the clavicles with normal light touch examination. There was generalized areflexia with extensor plantar responses.