Head/Neck Injury - Wrestling

HISTORY: This 23 y.o. male, former Olympic medalist, advanced to the final at the U.S. Greco-Roman World Team Trials. He engaged his opponent and landed on his head with his neck forced into an awkward position. His body immediately became limp. The wrestler did not recall the event and experienced abnormal sensation and inability to move his arms and legs. He soon regained motor function. PHYSICAL EXAMINATION: Retrograde amnesia regarding the injury event. "Pins and needles" sensation with normal motor in all extremities. DIFFERENTIAL DIAGNOSIS: Transient quadriplegia, Concussion, Anxiety, Munchausen Syndrome (Factitious disorder imposed on self) TEST AND RESULTS: MRI neck: C3-4 herniated disc. FINAL WORKING DIAGNOSIS: Transient quadriplegia due to acute C3-4 herniated disc, concussion. TREATMENT AND OUTCOMES: The head physician for the tournament assumed care on the mat. The athlete was cleared to wrestle. He subsequently underwent C3-4 diskectomy and fusion.