Transient Quadriplegia

Aka: Transient Quadriplegia, Cervical Cord Neuropraxia

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II. Epidemiology

  1. Incidence: 1.3% per 10,000 athletes

III. Risk Factors

  1. Cervical Spinal Stenosis
  2. Cervical Disc Herniation

IV. Mechanism

  1. Neck Hyperextension
  2. Neck Axial Loading

V. Symptoms

  1. Bilateral burning pain or Paresthesias
  2. Strength loss in the affected extremities
    1. Mild weakness to complete paralysis
  3. Sensation loss in the affected extremities

VI. Imaging

  1. Cervical Spine Imaging is required to exclude other causes
    1. See Cervical Spine Imaging in Acute Traumatic Injury

VII. Management

  1. Treat as Cervical Spine Injury if any persistent neurologic deficit
    1. See Cervical Spine Injury
    2. Transient Quadriplegia is a diagnosis of exclusion
    3. Perform Cervical Spine Immobilization
    4. EMS Transport to Emergency Department for Cervical Spine evaluation
  2. Spine Consultation
    1. No further sports participation until evaluation by spine specialist (even if asymptomatic)

VIII. Course

  1. Transient Quadriplegia may persist up to 36 hours

IX. References

  1. Kalsi, Kaufman and Hudson (2018) Crit Dec Emerg Med 32(10): 3-10

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