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Neurogenic Shock – Symptoms, Causes, Treatment

Written by Dr.Mary

What is a Neurogenic Shock?

A shock is considered to be a life-threatening condition wherein there is insufficient supply of blood flow to the body. There are five common types of shock and one of the most striking in the neurogenic shock. Neurogenic type of shock occurs when there is an injury to the central nervous system e.g., the brain and the spinal cord, disrupting in the function of the nervous system, affecting the blood distribution throughout the body.

The other types of shock are cardiogenic (heart problems), hypovolemic (inadequate blood volume), anaphylactic (allergic reaction), and septic (infections).

Although these types of shock may have different and specific causes, but most of them show the same manifestations.

Neurogenic Shock Symptoms

  • Low blood pressure – it usually reaches up to 60 mmHg
  • Increased heart rate – it reaches more than 120 beats per minute.
  • Difficulty breathing – the acts of breathing needs more effort than the usual and normal breathing pattern.
  • Pale skin – this happens because there is already a reduced number of red blood cells in the circulation.
  • Hyperhidrosis – Normal sweating happens all the time most especially in warm environment. However, hyperhidrosis is an abnormal and excessive sweating even when the body is not exposed to warm temperature.
  • Lethargy – this is a manifestation of an impaired mental capacity. Most of those that are lethargic cannot think clearly so they have impaired judgment and associated symptoms which are the following:
    • Confusion
    • Anxiety
    • Difficulty speaking and walking
    • Hallucinations
    • Depression
    • Memory loss
  • Fainting – this happens when there is a short moment of unconsciousness followed by recovery. The following symptoms of fainting:
    • Dizziness
    • Lightheadedness
    • Flushing
    • Nausea
    • Excessive sweating
    • Palpitations
    • Rapid pulse
    • Weakness or fatigue
  • Cool limbs and warm skin
  • Confusion – Since the patient has impaired mental capacity, he would be unable to speak
  • Coma – the individual would be unconscious and does not react to stimulation

Neurogenic Shock Causes

Neurogenic shock can be due to a severe damage to the central nervous system such as the brain and the higher levels of the spinal cord especially the cervical and thoracic regions. The mechanism is that once the there is trauma, the sympathetic functions of the body will be disrupted which might lead to the relaxation of the blood vessels, thereby decreasing the blood flow to the entire system. If not promptly managed, neurogenic shock can be life-threatening as continuous insufficiency in blood supply will cause cell death and organ failure.

  • Heart problems – this can be associated with heart attack or heart failure. Cases like this would obviously affect the return of deoxygenated blood from the system to the heart and the distribution of oxygenated blood back to the system will also be diminished thus leading to cell death and organ failure.
  • Decreased blood volume secondary to bleeding or dehydration
  • Severe allergic reactions
  • Medications that can alter the normal flow of the blood throughout the body

Neurogenic Shock Treatment

  • Fluid replenishment is the best initial treatment of shock. Some institutions would utilize the use of pressor agents to maintain hemodynamic stability of the body.
  • The use of dopamine (Intropin)
  • Use of the antidiuretic hormone, vasopressin
  • Atropine – this will speeds up heart rate and increases cardiac output

Furthermore, here are the First Aid tips in managing shock:


  • Immediately call 911 for help.
  • Check for ABC (airway, breathing, and circulation). Begin CPR if necessary.
  • Even the person is breathing independently, always check the patient every 5 minutes until help arrives.
  • If there’s no identified injury and the patient is conscious, position him in shock position. Lay the patient I supine (on the back) and elevate the legs about 12 inches high. Make sure to not elevate the head. However, if raising the leg causes discomfort, position the patient in supine or flat lying.
  • Always provide appropriate first aid for wounds or injuries.
  • Always keep the patient comfortable by loosening tight clothing.

What happens if the person is vomiting?

  • To prevent the patient from choking, turn the head toward the side.
  • If spinal cord injury is probable, keep the person’s head, neck, and back in the same level. Log roll the person if possible.

The following are things to avoid:

  • Do not give anything by mouth whether liquid or solid to prevent choking.
  • Do not to move the person if spinal cord injury is probable.
  • Do not wait for mild symptoms to get worse before calling for help by emergency medical service.

It is always necessary to know ways on how to prevent cases such as heart disease, dehydration, and other scenarios that may lead to shock. If someone is showing symptoms of shock, it is always necessary to attend to the person immediately to prevent life-threatening results.

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