Disorders of the spinal cord, nerves, root

Question 1

Herpes zooster clinical symptoms

Answer 1

very uncomfortable, sharp pain and paresthesias in the dermatome

Question 2

Herpes zooster infection

Answer 2

The infection can spread from the spinal ganglion towards the spinal cord.
Involvement of the anterior spinal cord horns causing flaccid paresis is rare, and hemiparessijor paraparesis are rarer

Question 3

Herpes booster localization

Answer 3

Normally thoracic

Question 4

Posterior spinal root syndrome

Answer 4

When two or more posterior nerve roots are severed, sensation in the corresponding dermatomes is lost.
Incomplete lesions of the posterior roots affect different sensory modalities, specially sense of pain
Hyporonia and hyporeflexia or reflexiva (because the lesion interrupts the peripheral reflex arc

Question 5

Posterior spinal cord bundle syndrome

Answer 5

Lesiones in the posterior column: loss of position and vibration sense, loos of tactile discrimination and stereognoisa . Positive Romberg test. Sensory ataxia. Pain hypersensitivity

Question 6

Posterior spinal cord bundle syndrome

Answer 6

B12 deficiency, vacuolar myelopathy, spinal cord compression, syphilitic myelopathy

Question 7

Posterior horn syndrome

Answer 7

Epicritical and proprioceptive sensation are preserved
Affected sense of paining temperature in the ipsilateral segment

Question 8

Posterior horn syndrome etiology

Answer 8

Siringomyelia, haematomyelia, intramedullary spinal cord tumors

Question 9

Central grey syndrome. Structures damaged and what causes

Answer 9

Spinothalamic striatum–> analgesia and thermanasthesia on both sides of the dermatome. Sense of touch preserved
Corticospinal tracts–> pyramidal signs (spastic mono paresis or paraparesis from the site of the defect downwards)
Grey of the anterior horn could be damaged–> signs of lower motor neuron damage with atrophy, paresis and arreflexia in the affected segment.
Atrophy is usually in the upper limbs and pyramidal signs in the lower

Question 10

Central grey syndrome aetiology

Answer 10

Syringomyelia, haematomyeliaq, centrally located intramedullary tumors

Question 11

Part of the spinal cord most commonly affected by Syringomyelia and what causes

Answer 11

Cervical
Causes analgesia and thermanasthesia over the shoulders and upper limbs and can also cause Horner’s syndrome.

Question 12

Syringobulbia causes

Answer 12

unilateral atrophy of the tongue, facial hypalgesia or analgesia and nistagmus

Question 13

Combined posterior bundle sheath and corticoespinal tract lesion syndrome clinical features

Answer 13

Loos of positional sensation in the lower limbs and loss of vibration sensation in the feet (leading to sensory ataxia and a positive Romberg test)
Corticospinal involvement: spastic paraparesis with hyperreflexia, extensor plantar response in the lower limbs
Weakness of the tendon reflexes in the most distal parts of the lower limbs (Achilles disappear, Patellar strengthened)

Question 14

Combined posterior bundle sheath and corticoespinal tract lesion syndrome aetiology

Answer 14

B12 deficiency

Question 15

Anterior horn syndrome clinical features

Answer 15

Loss of cell in the anterior horns of the spinal grey matter: paralysis of the muscle (proximal more affected)
Muscle atrophy

Question 16

Combined anterior horn and pyramidal tract syndromes seen in

Answer 16

amyotrophic lateral sclerosis

Question 17

Combined anterior horn and pyramidal tract syndromes is caused by

Answer 17

degeneration of conical and spinal neurons

Question 18

Combined anterior horn and pyramidal tract syndromes. Clinical features

Answer 18

Muscle atrophy
If there is affectation of the LMN deep tendon reflexes can be absent but if UPM is involved, reflexes can be exaggerated
Dysarthria and dysphagia

Question 19

Corticoespinal tract syndrome aetiology

Answer 19

Primary lateral sclerosis and spastic spinal palsy

Question 20

Corticoepinal trct syndrome clinical features

Answer 20

Feeling of heaviness in the lower limbs that progress to muscle weakness.
Spastic paraparesis develops and worsens

Question 21

Combined posterior bundle, spinocerebellar and pyramidal streak syndrome aetiology

Answer 21

Friedreich’s spinocerebellar ataxia, other ataxias

Question 22

Combined posterior bundle, spinocerebellar and piramidal streak syndrome. Clinical features

Answer 22

Destruction of the posterior columns–> loos of positional and vibration sense. Loss od tactile discrimination and stereognosis below the level of the defect.
Positive Romberg test
Ataxia (spinocerebellar line affected)
Gait becomes spastic (pyramidal lines progressively degenerate)

Question 23

Half spinal cord impairment: Brown -Sequard syndrome. Clinical features

Answer 23

Destruction of the posterior column: ipsilateral loss of positional sensitivity and vibration sense and tactile discrimination below the level of failure
Destruction of the lateral spinothalamic tract: contralateral analgesia and thermanasthesia

Question 24

Descending pathways affected by hemisection causes

Answer 24

ipsilateral signs of UMN damage: spastic ipsilateral paresis , hyperreflexia, Babinski impairment

Question 25

Destruction of the anterior horns of the spinal grey matter causes

Answer 25

Peripheral motor neuron damage (placid paralysis) in the damage segment

Question 26

Irritation of the dorsal spinal roots causes

Answer 26

Paresthesias or radicular pain in the dermatomes

Question 27

Damage to the sympathetic pathways in the T1 segment causes

Answer 27

Ipsilateral Horner’s syndrome

Question 28

Neuroapraxia

Answer 28

loos of motor and sensory function due to blockage of nerve conduction

Question 29

Axonotmesis

Answer 29

myelin sheath is damage

Question 30

Neurotmesis

Answer 30

transection of peripheral nerve

Question 31

Entrapment neuropathies

Answer 31

Carpal tunnel syndrome
Cubital tunnel syndrome
Meralgia paresthetica