Neuromuscular: Spinal Cord Injury: Clinical Syndromes

Question 1

SCI: Clinical Syndromes: Complete Cord Lesion

*UMN

Answer 1

• Complete bilateral loss of all sensory modalities
• Bilateral loss of motor function
• Spastic paralysis below the level of lesion
• Loss of bladder and bowel function
• Spastic bladder and bowel

Question 2

SCI: Clinical Syndromes: Central Cord Syndrome: Presentation

Answer 2

• Loss of more centrally located cervical tracts and arm function.
• Preservation of more peripherally located lumbar and sacral tracts and leg function
• Typically caused by hyperextension injuries to the cervical spine

Question 3

SCI: Clinical Syndromes: Central Cord Syndrome: Deficits

Answer 3

• Cavitation of the more central portion of the cervical section
• Loss of spinothalamic tracts with bilateral loss of PAIN AND TEMPERATURE
• Loss of ventral horn with bilateral loss of motor function, primarily in the upper extremities
• Preservation of PROPRIOCEPTION and DISCRIMINATORY SENSATION.

Question 4

SCI: Clinical Syndromes: Brown-Sequard Syndrome: Presentation

Answer 4

• Hemi-section of spinal cord typically caused by penetration wounds.
• Asymmetrical Symptoms

Question 5

SCI: Clinical Syndromes: Brown-Sequard Syndrome: Deficits

Answer 5

• Ipsilateral loss of dorsal columns with loss of TACTILE DISCRIMINATION, PRESSURE, VIBRATION, and PROPRIOCEPTION.
• Ipsilateral loss of corticospinal tracts with loss of motor function and spastic paralysis below level of lesion
• Contralateral loss of spinothalamic tract with loss of PAIN and TEMPERATURE below level of lesion
• Bilateral loss of pain and temperature AT the level of the lesion.

Question 6

SCI: Clinical Syndromes: Anterior Cord Syndrome: Presentation

Answer 6

• Damage to anterior cord
• Impairment to motor function, pain and temperature
• Preservation of light touch, proprioception, and position sense
• Typically caused by flexion injuries of the cervical spine

Question 7

SCI: Clinical Syndromes: Anterior Cord Syndrome: Deficits

Answer 7

• Damage to lateral corticospinal tracts with BILATERAL loss of motor function
• Spastic paralysis below level of lesion
• Damage to spino-thalamic tracts with bilateral loss of PAIN AND TEMPERATURE
• Preservation of dorsal columns including proprioception, kinesthesia, vibratory sense

Question 8

SCI: Clinical Syndromes: Posterior Cord Syndrome: Presentation

Answer 8

• Damage to posterior cord
• Loss of posterior columns
• Preservation of motor function, sense of pain, and light touch
• Extremely rare

Question 9

SCI: Clinical Syndromes: Posterior Cord Syndrome: Deficits

Answer 9

• Damage to dorsal columns bilaterally
• Bilateral loss of PROPRIOCEPTION, VIBRATION, PRESSURE, STEROGNOSIS, TWO POINT DISCRIMINATION
• Preservation of motor function, sense of pain, and light touch

Question 10

SCI: Clinical Syndromes: Cauda Equina: Presentation

Answer 10

• Injury below L1
• Injury to lumbar and sacral roots of peripheral nerves
• Sensory loss
• Paralysis
• Some capacity for regeneration
• Autonomous/nonreflex bladder

Question 11

SCI: Clinical Syndromes: Cauda Equina: Deficits

Answer 11

• Variable nerve root damage
• Incomplete lesions
• Flaccid paralysis
• No spinal reflex activity
• Flaccid paralysis of bladder and bowel
• Potential for nerve regeneration, typically slow and incomplete and stops after around 12 months

Question 12

SCI: Clinical Syndromes: Sacral Sparing: Deficits

Answer 12

• Sparing of tracts to sacral segments
• Preservation of perineal sensation
• Preservation of Rectal sphincter tone
• Preservation of active toe flexion