medical diseases of the spinal cord

Question 1

Describe the presentation of an upper motor neuron lesion

Answer 1

• No wasting of muscle
• Increased tone
• Increased reflexes and extensor plantar
• Usually bilateral

Question 2

Describe brown sequard syndrome

Answer 2

Hemisection of the spinal cord - the noiciceptive spinothalmic tract decussates in the grey matter at the level of the spinal cord while the dorsal column tract decussates higher up at the medulla:
-spinothalamic is pain and temp and therefore the lesion is contralateral to level of lesion
Dorsal column is vibration, weakness and joint position sense which decrease ipsilateral side of lesion because decussation is above the level of the lesion

Question 4

What is best imaging modality for spinal issues

Answer 4

MRI

Question 5

What is the presentation of a spinal cord stroke

Answer 5

• Sudden onset or over several hours
• Back pain
• paraparesis - partial paralysis of the lower limbs
• numbness and parasthesia
• urinary retention followed by incontinence

Question 6

What is the treatment of a spinal cord stroke

Answer 6

• OT and physiotherapy
• Reduce risk of recurrence with mantainence of adequate blood pressure and antiplatelet therapy
• Reverse the hypovolaemia

Question 7

What is the presentation of B12 defficiency myelopathy

Answer 7

• Parasthesia in the hands and feet
• areflexia - weak deep tendon reflexes
• Degreneration of the corticospinal tract - paralysis of lower limb
• Degeneration of dorsal columb - sensory ataxia
• painless urinary retention

Question 8

What is the treatment for B12 deficient myelopathy

Answer 8

Intramuscular B12