Korean J Neurotrauma.  2015 Oct;11(2):147-150. 10.13004/kjnt.2015.11.2.147.

Effect of Alpha-1-Adrenergic Agonist, Midodrine for the Management of Long-Standing Neurogenic Shock in Patient with Cervical Spinal Cord Injury: A Case Report

• Kim T
• Jwa CS

• KMID: 2378275
• DOI: http://doi.org/10.13004/kjnt.2015.11.2.147

Abstract

We report a rare case of a 71-year-old male patient who had suffered from long-lasting neurogenic shock for 13 weeks after cervical spinal cord injury (SCI) caused by a bicycle accident. The neurogenic shock was resolved dramatically 2 weeks after the administration of alpha-1-adrenergic agonist, midodrine hydrochloride. In usual cases, neurogenic shock tends to improve between 2 and 6 weeks after SCI; however, in a few cases, the shock lasts for several months. In our case, spinal shock lasted for 13 weeks and exhibited very sensitive decline of blood pressure for even a slight decrease of dopamine despite recovered bulbospongiosus reflex. Three days after midodrine hydrochloride was added, hypotension improved dramatically. We discuss our rare case with pertinent literatures.

Keyword

Adrenergic alpha-agonists; Hypotension; Midodrine; Spinal cord injuries

MeSH Terms

Adrenergic alpha-Agonists
Aged
Blood Pressure
Dopamine
Humans
Hypotension
Male
Midodrine*
Reflex
Shock*
Spinal Cord Injuries*
Spinal Cord*
Adrenergic alpha-Agonists
Dopamine
Midodrine