Spastic paraparesis Flashcards

1
Q

Signs in Spastic Paraparesis

A

Scissor gait
Disuse atrophy and contractures
Hypertonia, hypereflexia and upgoing plantars
Ankle clonus
Generalised weakness

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2
Q

Causes of Spastic Paraparesis

A

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

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3
Q

Management of Spastic Paraparesis

A

Conservative:
PT -> Stretches + strengthening exercises, orthoses + casts

Medical:
Pharmacotherapy
-> Benzodiazepines
-> Baclofen
-> Clonidine
-> Gabapentin

Neurosurgery

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