Spinal Cord Clinical Syndromes

Question 1

What is Spinal Muscular atrophy?

Answer 1

Congenital degeneration of cells in the anterior horns of spinal cord

LMN lesion with symmetric weakness, diffuse proximal muscle weakness

Also called Werdnig Hoffman disease

Question 2

What is amyotrophic lateral sclerosis?

Answer 2

Heterogeneous group of neurodegenerative diseases in which both UMNs and LMNs degenerate.

Progressive loss of anterior horn cells, CST neurons in motor cortex

Combination of UMN and LMN symptoms

Progressive onset starts with weakness in one area of the body, moves to other areas

Question 3

Describe the symptoms of an occlusion of the anterior spinal artery?

Answer 3

UMN deficit below the lesion (CST)

LMN deficit at level of lesion (Anterior horn)

Loss of temperature and pain sensation below lesion

Question 4

What is Tabes Dorsalis?

Answer 4

Caused by tertiary syphilis

Demyelination of dorsal columns and roots

Progressive sensory ataxia, impaired proprioception, romberg sign

Question 5

What is Syringomyelia?

Answer 5

Syrinx expands and damages the anterior white commissure of spinothalamic tract

Causes bilateral loss of pain and temperature in a cape-like pattern

Question 6

What neurodegenerative diseases is caused by Vitamin B12 deficiency?

Answer 6

Subacute combined degeneration

Demyelination of spinocerebellar tracts, lateral corticospinal tracts, dorsal columns

Causes ataxic gate, paresthesia, impaired position and vibration sense

Question 7

What is Cauda Equina Syndrome?

Answer 7

Compression of spinal roots L2 and below

Often due to disc herniation

Symptoms: Unilateral radicular pain, absend knee and ankle reflex, loss of bladder and anal sphincter reflex control, saddle anesthesia

Question 8

What is poliomyelitis?

Answer 8

Poliovirus causes destruction of cells in the anterior horn

LMN signs - asymmetric weakness, hypotonia, flacid paralysis, fasciculations

Question 9

What is Brown-sequard syndrome?

Answer 9

Hemisection of the spinal cord

Ipsilateral loss of all sensation at level of lesion, Ipsilateral LMN signs at level of lesion, Ipsilateral UMN signs below level of lesion, Ipsilateral loss of dorsal column functions

Contralateral loss of pain, temperature and non-discriminative touch below the lesion