Abstract
Spinal cord lesion site is mainly localised through correct performance and interpretation of a full neurological examination. Decreased or absent spinal reflexes localises the lesion within that reflex arc (low motor neuron), while intact or increased spinal reflexes indicates a lesion cranial to the reflex arc (upper motor neuron). In acute and severe spinal cord injury, lesion localisation may be compromised by the presence of spinal shock, because in individuals with spinal shock, the clinical presentation shows discrepancy between spinal reflexes and lesion localisation, with loss of segmental spinal reflexes caudally to a lesion, although the intumescence may remain intact. Lack of recognition of spinal shock in these patients could lead to erroneous clinical localisation of the lesion, inappropriate utilisation of diagnostic tests and incorrect reporting of patient prognosis to the owner.
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