Disease of Spinal Cord and Nerve Roots

Question 1

non-compressive causes of a spinal cord lesion

Answer 1

MS, sarcoid, ischaemia, haemorrhage, B12 deficiency

herpes simplex, EBV, HIV, TB, syphilis, idiopathic

Question 2

what is brown-sequard syndrome

Answer 2

when the lesion is only affecting half the spinal cord

Question 3

presentation of brown-sequard syndrome

Answer 3

ipsilateral loss of vibration, JPS, proprioception weakness

contralateral loss of pain and temperature

Question 4

in which type of lesion do you find hypotonia and loss of reflexes

Answer 4

LMN

Question 5

sensory loss in radiculopathy

Answer 5

nerve root affected –> loss of sensation in that dermatome

Question 6

how does a spinal cord stroke present

Answer 6

back pain (maybe referred viscerally)
weakness
numbness
paraesthesia
urinary/bowel incontinence

Question 7

what imaging is used to see the spinal cord

Answer 7

MRI

Question 8

what artery is usually affected in a spinal cord stroke

Answer 8

anterior spinal artery

Question 9

which region of the spinal cord does a stroke usually occur

Answer 9

mid-thoracic

Question 10

preventative therapy in spinal cord stroke

Answer 10

antiplatelet, BP control, lifestyle risk factors, rhythm control

Question 11

immediate management of spinal cord stroke

Answer 11

fluids, analgesia

Question 12

what is contradictive about the way B12 deficiency presents

Answer 12

mixture of UMN and LMN signs: absent reflexes but extensor plantar response

Question 13

what is paraplegia

Answer 13

loss of motor and sensory function in lower limbs

Question 14

what is quadraplegia

Answer 14

loss of motor and sensory function in all 4 limbs

Question 15

immeadiate treatment of B12 deficiency

Answer 15

intramuscular B12

Question 16

what is cauda equina syndrome

Answer 16

compression of nerves distal to the spinal cord termination (L1-L2)

Question 17

where does the spinal cord terminate

Answer 17

L1-L2

Question 18

where are LP done in the spinal cord

Answer 18

L3-4/L4-5

Question 19

how does cauda equina syndrome present

Answer 19

lower back pain
bilateral lower limb weakness and sensory loss
perineal anaesthesia
urinary retention/incontinence
sexual dysfunction
bowel dysfunction

Question 20

management of cauda equina syndrome

Answer 20

REALLY JUST DEPENDS OF THE CAUSE
immobilise spine (if trauma)
surgery (if abnormality needing removed)
anti-inflammatories (steroids)
antibiotics
chemo/radio