Sensiry Disturbance

Question 1

Notes on examination

Answer 1

Pseudoathetosis - rhombergs for the upper limbs, ask pt to hold
Hands out and spread fingers. Will wonder if proprioception deficit

Question 2

Peripheral causes

Answer 2

Radiculopathy
Peripheral neuropathy
- symmetrical vs assymetrical causes

Question 3

Central causes

Answer 3

Total transaction of cord

Hemisection of cord (brown-sequard) - ipsilateral Weakness and dorsal column (light touch, 2 point discrimination, proprioception, vibration loss) impairment AND contralateral pain and temperature loss

Central cord syndrome (eg syringomyelia) - bilateral impairment of pain and temperature, dorsal columns spared

Anterior spinal artery syndrome - spinothalamoc tract impairment, dorsal column sparing

Posterior column syndrome: impaired light touch, 2 point discrimination, proprioception, vibration sense. Intact spinothalamic

Lateral medulla (lateral medullary syndrome) - ipsilateral impaired pain and temp of face, contralateral impaired pain and temp of body

Medial medulla - dorsal column impairment contralateral side of face bit intact facial sensation