radiculopathy

Question 1

what is radiculopathy?

Answer 1

conduction block in the axons of spinal nerves or roots

1. motor axons - causes weakness
2. sensory axons - causes parasthesia

Question 2

what are the causes of radiculopathy?

Answer 2

1. intervertebral disc prolapse - usually lumbar
2. degenerative disease of the spine - e.g. spinal canal stenosis - most commonly cervical spine
3. malignancy
4. infection

Question 3

what are the clinical features of radiculopathy?

Answer 3

1. sensory - parasthesia and numbness
2. motor - weakness
3. radicular pain - burning, deep strap like pain (arises due to irritation of the spinal nerve tissue)

Question 4

what needs to be assessed?

Answer 4

1. red flags for cauda equina

2. pin point the dermatomal and myotomal involvement

Question 5

what are the red flags for cauda equina syndrome?

Answer 5

1. faecal incontinence
2. urinary rention
3. saddle anaesthesia

Question 6

Mx

Answer 6

1. analgesia
2. amitryptyline - first line
3. benzos for muscle spasm
4. physiotherapy