Transient quadriparesis in the athlete.

A considerable amount of controversy persists regarding return-to-play criteria and the risk for more severe injury after an athlete experiences an episode of transient quadriparesis. Similarly, the implication of the presence of congenital stenosis in an athlete participating in contact sports elicits great debate in the literature in terms of the athlete's risk for neurologic injury. The relatively infrequent occurrence rate of both transient quadriparesis and permanent cervical cord injury make it difficult to predict with certainty whether or not an episode of transient quadriparesis is a risk factor for permanent neurologic injury. The decision-making process in determining player eligibility in the face of congenital stenosis or after a documented spinal injury is difficult and at times confusing. Every injury and athlete should be evaluated on an individual basis in terms of cause, symptoms, radiographic findings, and previous history. It is hoped that the guidelines for return-to-play delineated in this article will help the physician and the athlete make an informed and rational decision regarding the criteria for and relative risks of returning to participation in a contact sport.