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Year 3 - Neuro > Spinal Cord Disorder > Flashcards

Spinal Cord Disorder Flashcards

1
Q

What is spondylosis?

A

Non-specific OA or degenerative change affecting the spine

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2
Q

Who does cervical spondylosis mostly affect?

A

> 50

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3
Q

Give examples of common findings in spondylosis

A

Osteophytes
Ligament hypertrophy
Nerve root compression

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4
Q

What are the clinical features of cervical spondylosis?

A

Neck pain
Arm pain
Weakness
Paraesthesia

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5
Q

What does MRI show in spondylosis?

A

Compression of nerve roots

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6
Q

What is the management of mild cervical spondylosis?

A

Neck collar

Analgesia

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7
Q

What is the management of severe cervical spondylosis?

A

Surgical decompression

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8
Q

What risks are involved in decompression surgery for spondylosis?

A

Paralysis
CSF leak
Spinal instability

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9
Q

What is a lumbar spinal stenosis?

A

Narrowing of the central spinal canal in the lumbar spine

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10
Q

Which age group is most commonly affected by lumbar spinal stenosis?

A

> 50

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11
Q

Give congenital causes of lumbar spinal stenosis

A

Achondroplasia
Scoliosis
Congenital spondylolisthesis

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12
Q

Give causes of acquired lumbar spinal stenosis

A

Degenerative
Iatrogenic
Traumatic
Inflammatory

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13
Q

What are the clinical features of lumbar spinal stenosis?

A

Chronic progressive lower back, butt and leg pain bilaterally
Paraesthesia in legs bilaterally
Claudication better on bending forward (cycling, walking uphill, etc)

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14
Q

What does examination of lumbar spinal stenosis show?

A

Positive straight leg raise

Mild motor/sensory deficits

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15
Q

What investigation is done on suspicion of lumbar spinal stenosis?

A

MRI

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16
Q

How is lumbar spinal stenosis managed first line?

A

NSAIDs
Gabapentin
Steroid injection into the epidural space

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17
Q

When would decompressive surgery be offered in lumbar spinal stenosis?

A

Neuro symptoms
Not aided by medication
Significant evidence of compression

18
Q

Give causes of cauda equina syndrome?

A 
Herniated lumbar disc
Tumour
Haemorrhage
Fracture
Abscess
19
Q

How does cauda equina present?

A

Severe lower back and leg pain
Leg weakness bilaterally
Saddle anaesthesia
Bowel/bladder dysfunction

20
Q

What does examination show in cauda equina syndrome?

A

LMN weakness
Loss of reflexes
Reduced anal tone

21
Q

What investigation is carried out in cauda equina syndrome suspicion?

A

MRI

22
Q

How is cauda equina syndrome managed?

A

Surgical decompression within 24 hours

23
Q

What is syringomyelia?

A

Development of a fluid filled cystic cavity in the central canal of the spinal cord

24
Q

What is syringobulbia?

A

Development of a fluid filled cystic cavity in the brainstem

25
Q

What congenital abnormality is syringomyelia associated with?

A

Arnold-Chiari malformation

26
Q

What is an Arnold-Chiara malformation?

A

Low lying cerebellar tonsils which extend through the foramen magnum

27
Q

What are the clinical features of syringomyelia?

A

Gradual progression
LMN symptoms at level of the lesion
Loss of pain and temp sensation
UMN features below the level of the lesion

28
Q

How is syringomyelia/bulbia investigated?

A

MRI

29
Q

How is syringomyelia treated?

A

Surgical decompression

30
Q

How does spinal cord infarction present?

A

Sudden, severe back pain with acute onset of neuro symptoms

31
Q

How does an anterior spinal artery infarct present?

A

Loss of pain and temp sensation

32
Q

How does a posterior spinal artery infarct present?

A

Loss of fine touch and vibration

33
Q

How is spinal cord infarction investigated?

A 
MRI
Nerve conduction studies (to rule out GB)
Coag screen (for thrombophilia) 
Angiogram (for malformation)
Echo (cardiac embolism)
Antibody screen
34
Q

What is transverse myelitis?

A

Acute inflammation of the spinal cord

35
Q

What are the clinical features of transverse myelitis?

A

Spontaneous para/tetraplegia developed over several days with bowel/bladder dysfunction and sensory loss

36
Q

How is transverse myelitis investigated?

A

MRI

37
Q

How is transverse myelitis managed?

A

High dose steroids to reduce inflammation

38
Q

What is subacute combined degeneration of the cord?

A

Myelopathy and peripheral neuropathy as a result of decreased vit B12

39
Q

What does MRI show in subacute combined degeneration of the cord?

A

Hyperintense posterior cord

40
Q

How is subacute degeneration of the cord managed?

A

Vit B12 supplements

Year 3 - Neuro (19 decks)

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