Myelopathies- Terms

Question 1

Lower sacral myelopathy and cauda equina syndrome

Answer 1

Dsyfunction of S3 and below or the spinal nerves or roots in inferior cauda equina
Somatosensory abnormalities in perineum
No obvious UMN or LMN abnormalities
Can have loss of control of urination, defecation, genital function

Question 2

Lumbosacral enlargement myelopathy

Answer 2

Dysfunction of lower lumbar or upper sacral spinal cord
Somatosensory abnormalities at the level of the lesion and below
LMN abnormalities at the level of the lesion and UMN abnormalities below the lesion
Can have loss of control of urination, defecation, genital function

Question 3

Thoracic myelopathy

Answer 3

Dysfunction of the thoracic spinal cord
Somatosensory abnormalities of all of the dermatomes inferior to a horizontal line encircling the chest
Spastic paraparesis: LMN abnormalities at the level of the lesion and UMN signs of all myotomes below the lesion
Loss of control of urination, defecation, genital function

Question 4

Cervical enlargement myelopathy

Answer 4

Dysfunction of lower cervical spinal cord
Somatosensory abnormalities of all dermatomes below the level of the lesion
LMN abnormalities at the level of the lesion

Question 5

Upper cervical myelopathy

Answer 5

Dysfunction of the upper cervical spinal cord
Somatosensory abnormalities of all levels below a horizontal line encircling the neck
Spastic quadriparesis, LMN abnormalities at th elevel of the lesion and UMN abnormalities below the level of the lesion; pronator drift, slowed fine finger movements, respiratory muscle weakness
Loss of control of urination, defecation, genital function

Question 6

Unilateral myelopathy

Answer 6

Unilateral lesion of spinal cord at one level
Ipsilateral somatosensory abnormalities of all modalities at the level of the lesion; loss of position/ vibration/ fine touch at all ipsilateral dermatomes below the lesion; loss of pain/ temp/ gross touch at all contralateral dermatomes below the lesion
Ipsilateral LMN abnormalities at the level of the lesion; UMN abnormalities at all ipsilateral myotomes below the lesion

Question 7

Posterior spinal artery syndrome

Answer 7

Occlusion of one of the posterior spinal arteries
Loss of all somatosensory modalities of the ipsilateral dermatome at the level of the lesion
Loss of position, vibration, fine touch from all ipsilateral dermatomes below the lesion
No motor abnormalities

Question 8

Anterior spinal artery sundrome

Answer 8

Dysfunction of the anterior spinal artery
Bilateral loss of pain/ temp/ gross touch below the level of the lesion
Bilateral LMN abnormalities at the level of the lesion; bilateral UMN abnormalities of all myotomes below the lesion
Loss of control of urination, defecation, genital function