Must Know Spinal Cord Lesions in Ten Minutes
| DISEASE | CHARACTERISTICS
|
| Spinal muscular atrophy Polio | Destruction of anterior horn cells and flaccid paralysis
|
| Neuromyelitis Optica | Anti Aquaporin 4 antibody causing demyelination in white matter of spinal cord. Cervical spine involvement will cause quadriplegia
|
| Brown-Séquard Hemi-section
| Ipsilateral band of hyperesthesia at level of lesion Ipsilateral loss of proprioception below level of lesion Ipsilateral hemiparesis Contralateral loss of pain and temperature sensation one to two levels below lesion
|
| Amyotrophic lateral sclerosis | Asymmetric muscle weakness of legs and arms Combined UMN and LMN deficits Commonly presents as fasciculations with eventual atrophy and weakness of hands; Riluzole is used to improve survival
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| Complete occlusion of anterior spinal artery | Spares dorsal columns. Sensory-motor dissociation Occurs after abdominal aorta surgery |
| Central cord syndrome
| Weakness more pronounced in upper extremities than lower extremities
Caused by hyperextension injuries of spine
|
| Tabes dorsalis seen due to tertiary syphilis | Lhermite sign Bladder incontinence Progressive sensory ataxia (inability to sense or feel the legs) poor coordination. Rhomberg sign due to impaired sensation and proprioception Associated with Charcot joints (repeated unknowing trauma to joint caused by lack of pain) Argyll Robertson pupils |
| Syringomyelia
| Caused due to Arnold chiari syndrome type 1 Syrinx (CSF-filled cavity within spinal cord) expands and damages anterior white commissure of spinothalamic tract. Results in a cape-like, bilateral loss of pain and temperature in upper extremities |
| Vitamin B12 deficiency | Subacute combined degeneration-demyelination of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts; ataxic gait, paresthesia, impaired position and vibration sense |
| Cauda equina syndrome | Compression of spinal roots L2 and below, most likely caused by disc herniation; saddle anesthesia, loss of bladder and anal sphincter control, and absent knee and ankle jerk reflexes |