MIDTERMS: TRANSVERSE MYELITIS & SPINAL TUMORS

Question 1

What characterizes transverse myelitis?

Answer 1

It involves an acutely inflammatory-demyelinative lesion affecting a section of the spinal cord, specifically the myelin sheaths and oligodendrocytes.

Question 2

Which part of the spinal cord is most commonly affected by transverse myelitis?

Answer 2

The thoracic region.

Question 3

What laboratory findings are typically associated with transverse myelitis?

Answer 3

CSF analysis shows lymphocytes and increased proteins, while MRI reveals focal areas of demyelination.

Question 3

What are some common symptoms of transverse myelitis?

Answer 3

Rapidly evolving symptoms including symmetrical/asymmetrical paraparesis or paraplegia, ascending paresthesias, loss of deep sensation in the feet, sensory level on the trunk, sphincter dysfunction, and bilateral Babinski signs.

Question 3

What is the primary treatment approach for transverse myelitis?

Answer 3

The treatment focuses on reducing inflammation with corticosteroids, controlling pain, and providing rehabilitation and good nursing care.

Question 3

What is the prognosis for individuals with transverse myelitis?

Answer 3

Improvement can take months, and most individuals experience no long-term problems due to remyelination and the stunned state of good cells leading to less permanent damage.

Question 3

What are the two main groups of spinal tumors?

Answer 3

Intramedullary tumors (within the spinal cord) and extramedullary tumors (outside the spinal cord).

Question 3

What does lumbar puncture help diagnose in transverse myelitis?

Answer 3

It helps in the analysis of cerebrospinal fluid (CSF) and may involve checking for oligoclonal bands associated with multiple sclerosis or other disorders.

Question 3

What are some potential causes of transverse myelitis?

Answer 3

Causes include viral infections, autoimmune responses, post-vaccination reactions, and brain-related issues.

Question 3

What are the types of extramedullary tumors?

Answer 3

Extradural (in vertebral bodies and epidural tissues) and intradural (in leptomeninges and nerve roots).

Question 4

What are the most common primary intramedullary tumors?

Answer 4

Ependymomas (60%) and astrocytomas (25%), along with oligodendrogliomas and non-gliomatous tumors like lipomas and hemangiomas.

Question 4

What are the most common primary extramedullary tumors?

Answer 4

Neurofibromas, meningiomas, sarcomas, vascular tumors, chordomas, and epidermoid tumors.

Question 4

What is Froin syndrome, and what does it indicate?

Answer 4

Froin syndrome is characterized by xanthochromia and clotting of CSF, indicating an interruption of flow due to invasive tumors.

Question 4

What symptom patterns are associated with spinal tumors?

Answer 4

Pain and stiffness that worsens in recumbency, asymmetric spastic weakness, sensory level loss, and bladder dysfunction.

Question 4

What are common symptoms of spinal tumors in children?

Answer 4

Severe back pain, paravertebral spasms, scoliosis, and spastic weakness.

Question 4

What is the intramedullary syringomyelic syndrome?

Answer 4

A syndrome characterized by segmental sensory loss, amyotrophy, early incontinence, and corticospinal weakness.

Question 4

What treatments are available for spinal tumors?

Answer 4

Treatments include radiation (for epidural growths), endocrine therapy (for breast and prostate cancers), antineoplastic drugs (for lymphomas), high-dose steroids, analgesics, and surgical removal of tumors.

Question 4

What are the key symptoms of radicular-spinal cord syndrome?

Answer 4

Spinal cord compression, radicular pain, segmental sensory changes, motor disturbances, and a dull, knife-like ache.

Question 4

What surgical procedures are performed for spinal tumors?

Answer 4

Laminectomy, decompression, excision, and radiotherapy for intra- and extramedullary tumors.