Lecture 15/16: CIS Lesions

Question 1

Midbrain lesion of PCML

Answer 1

CL loss of PCML

Question 2

SC lesion of PCML

Answer 2

IL loss of PCML

Question 3

SC hemisection

Answer 3

CL loss of ALS about 2 segments below
IL loss of PCML
LMN loss at level
UMN IL loss below lesion

Question 4

Syringomyelia

Answer 4

BL loss of ALS

May effect the motor system (CST)

Question 5

Spinal trigeminal lesions

Answer 5

Onion-peel sensory loss.
Caudal lesion begins at mouth.
Rostral lesion (into Brainstem) begins at posterior head.

Question 6

UL lesion of trigeminal n.

Answer 6

Anesthesia and loss of sensation in trigeminal Dermatomes.

Question 7

Alternating analgesia

Answer 7

Lesion in upper medulla.
IL loss of pain to face.
CL loss of ALS to body

Question 8

Alternating trigeminal hemiplegia

Answer 8

UL destruction of CN V and CST in pons.

IL trigeminal loss of pain and CL spastic hemiplegia.

Question 9

Lesion of CST in medulla

Answer 9

CL loss of UMN

Question 10

CST lesion in the spinal cord

Answer 10

IL loss of LMN at level.

IL loss of UMN below lesion.

Question 11

Decorticating posturing

Answer 11

Lesion above red nucleus

Question 12

Decerebrate posturing

Answer 12

Lesion below red nucleus

Question 13

Complete transection of SC

Answer 13

All sensation (2 segments below for ALS)
Loss of bladder/bowel control.
Spinal shock
UMN loss IL below lesion.
LMN at level of lesion.

Question 14

Brown-Sequard syndrome

Answer 14

Hemisection of SC.

• CL ALS loss
• IL PCML loss
• IL UMN below lesion
• IL LMN loss at level

Question 15

Anterior cord syndrome

Answer 15

LCST loss
ALS loss CL

Problem with anterior spinal a.

Question 16

Central cord syndrome

Answer 16

Same as syringomyelia

Question 17

Medial medullary syndrome

Answer 17

Affects pyramids, ML, and hypoglossal nucleus.
CL UMN Sx
CL PCML Sx
IL loss of CN XII

Question 18

Lateral medullary syndrome

Answer 18

ALS loss on CL side
Spinotrigeminal tract loss on IL side
Nucleus ambiguous (CN X, XI) on IL side

Question 19

Central 7 palsy

Answer 19

CBT and CN VII affected.
CL loss on lower facial ms.
Upper facial ms. OK.

Question 20

BS to VPL and VPM

Answer 20

Thalamogeniculate branches of PCA

Question 21

BS to ALS in spinal cord

Answer 21

Anterior spinal a.

Question 22

BS to ALS in medulla

Answer 22

PICA

Question 23

BS to trigeminal structures in medulla

Answer 23

PICA and Posterior spinal a.

Question 24

Lateral medullary syndrome is a problem w/ which artery?

Answer 24

PICA

Question 25

Medial medullary syndrome is a problem w/ which artery?

Answer 25

Anterior spinal a.

Question 26

Weber syndrome

Answer 26

CL UMN Sx CL low face droop CN III - down and out eye Occlusion of P1 and basilar a.

Question 27

Acute poliomyelitis (2)

Answer 27

Fever | LMN Sx

Question 28

A.L.S.

Answer 28

LMN Sx - arophy UMN Sx - spasticity, hyperreflexia, clonus. Usually cranial nerve involvement. NO SENSORY DEFECTS

Question 29

Brown-Sequard

Answer 29

IL loss of PCMLS and CST | CL loss of ALS

Question 30

Partial transection of SC

Answer 30

Looks like transection of SC initially, but there is often some sensory improvement as time goes by

Question 31

Tabes dorsalis (3)

Answer 31

Hypersensitivity to cutaneous sensation. BL loss of PCML BL LMN Sx