Spastic paraparesis Flashcards
Signs in Spastic Paraparesis
Scissor gait
Disuse atrophy and contractures
Hypertonia, hypereflexia and upgoing plantars
Ankle clonus
Generalised weakness
Causes of Spastic Paraparesis
Multiple sclerosis -> Cerebellar signs
Cord compression -> Absence of signs above the lesion
Trauma
MND -> No sensory signs
Anterior spinal artery occlusion -> loss of spinothalamic
Syringomyelia -> LMN in upper limbs + loss of spinothalamic
Subacute combined degeneration (B12 deficiency) -> areflexia + upgoing plantars
Cervical myelopathy
Management of Spastic Paraparesis
Conservative:
PT -> Stretches + strengthening exercises, orthoses + casts
Medical:
Pharmacotherapy
-> Benzodiazepines
-> Baclofen
-> Clonidine
-> Gabapentin
Neurosurgery