diseases of the spinal cord and nerve roots Flashcards
what are some medical causes of myelopathy or radiculopathy?
inflammation infarction infiltration infection degenerative
what is myelopathy?
disease of the spinal cord
what are some surgical causes of myelopathy or radiculopathy?
tumour
vascula abnormalities (haemorrhage, dural fistula)
degenerative
trauma
what are some motor signs of upper motor neurone pathology?
no wasting
increased tone
increased reflexes
pyramidal pattern of weakeness
what are some motor signs of lower motor neurone pathology?
wasting
decreased tone
decreased reflexes
weakness
what are some sensory signs of radiculopathy?
dermatomal pattern of sensory loss
what are the symptoms of brown sequard syndrome?
paralysis and loss of proprioception on the ipsilateral side and a loss of pain and temperature sensation on the contralateral side
what are some signs of a C5 cord lesion?
wasting of C5 innervated muscles
increased tone in the lower limb compared to the upper limb
decreased reflexes in the biceps
increased reflexes in everything below the biceps
decreased power in C5 innervated muscles
what are some causes of spinal cord ischaemia?
atheromatous disease arterial dissection vasculitis venous occlusion systemic hypotension
how does a spinal cord stroke typically present?
can be sudden or gradual onset back pain and visceral referred pain weakness (usually paraparesis) numbness and paraesthesia urinary symptoms
what can account for the symptoms of a spinal cord stroke?
partial brown sequard syndome
spinal shock
what can present as a partial brown sequard syndrome?
occlusion of a central sulcal artery
how is a spinal cord stroke treated?
maintain adequate BP bed rest reverse hypovolaemia/arrythmia OT and physiotherapy manage vascular risk factors
what is demyelinating myelitis characterised by?
pathological lesions of inflammation and demyelination leading to temporary neuronal dysfunction
what area of the spinal cord does demyelinating myelitis affect?
white matter