Sensory Disturbance Patterns

Question 1

• Weakness
• All sensory modalities affected
• Hyporeflexia

Answer 1

• Peripheral Neuropathy (Alcoholism, Diabetes)

* Non-organic sensory disorders also commonly present in a glove-and-stocking distribution.

Question 2

• Decreased proprioception
• Decreased Romberg sign
• Sharp pains
• Lower extremities affected

Answer 2

• Neurosyphilis (Tabes Dorsalis). *Posterior columns are characteristically affected, leading to a Romberg sign (the patient falls with closed eyes due to loss of proprioception)

Question 3

Patient’s right side:
- Decreased pain & temp.
Patient’s Left side:
- Spastic Paralysis

• Decreased proprioception
• Hyperreflexia

Answer 3

Brown Sequard Syndrome

Question 4

• Radicular Pain (from lateral shoulder, arm, and down to thumb)* where is issue most likely located?

Answer 4

Cervical Roots C5-C6

Question 5

• Decreased pain and temperature
• Light touch and proprioception are intact
• typically across arms and chest

Answer 5

Syringomyelia. *Pain-temperature fibers crossing midline the spinal cord are affected. Cervical levels most commonly affected.
Often, there is atrophy of the small muscles of hand when lesion extends from the midline to adjacent motor horn cells.

Question 6

• Spastic paralysis
• Loss of all sensory modalities
• Hyperreflexia
• below belly button

Answer 6

Total Transection (T-11)

Question 7

• Weakness in elbow and wrist extension.
• Numbness in the dorsum of the hand
• Decreased triceps reflex

Answer 7

Radical Nerve Injury