Delayed Diagnosis of Spinal Cord Injury in a Patient With Intellectual Disability: A Case Report

A 63-year-old man with intellectual disability was admitted to the hospital after a fall. Initial examination did not reveal any trauma. He was later readmitted due to hypotension and bradycardia, initially suspected as sick sinus syndrome. Motor weakness and urinary retention led to the discovery of cervical cord injury and spondylosis. Due to the patient's intellectual disability, neurological examinations were difficult, complicating the initial diagnosis. The medical staff was unfamiliar with the patient’s usual condition, which further hindered the assessment of his neurological status. Cervical decompression surgery and rehabilitation therapy contributed to the improvement of the patient’s condition, highlighting the importance of considering spinal cord injury in patients with intellectual disability even in the absence of severe trauma.

• 1
  Initial presentation of spinal cord injury can be misleading, especially in patients with intellectual disabilities, leading to a delayed diagnosis.
• 2
  Hypotension and bradycardia following a fall were initially attributed to sick sinus syndrome before spinal cord injury was identified.
• 3
  MRI revealed cervical spondylosis and spinal cord injury, leading to cervical decompression surgery and subsequent improvement in the patient’s condition.