Spinal cord lesions

Question 1

Motor lesions include:

Answer 1

Amyotrophic lateral sclerosis (motor neuron disease)
- affects both upper (corticospinal tracts) and lower motor neurons
- results in a combination of upper and lower motor neuron signs

Poliomyelitis
- affects anterior horns resulting in lower motor neuron signs

Question 2

Brown-Sequard syndrome (spinal cord hemisection) tracts affected?

Answer 2

1. Lateral corticospinal tract
2. Dorsal columns
3. Lateral spinothalamic tract

Question 3

Brown-Sequard syndrome (spinal cord hemisection) Clinical notes:

Answer 3

1. Ipsilateral spastic paresis below lesion
2. Ipsilateral loss of proprioception and vibration sensation
3. Contralateral loss of pain and temperature sensation

Question 4

Subacute combined degeneration of the spinal cord (vitamin B12 & E deficiency) Tracts affected:

Answer 4

1. Lateral corticospinal tracts
2. Dorsal columns
3. Spinocerebellar tracts

Question 5

Subacute combined degeneration of the spinal cord (vitamin B12 & E deficiency) Clinical notes?

Answer 5

1. Bilateral spastic paresis
2. Bilateral loss of proprioception and vibration sensation
3. Bilateral limb ataxia

Question 6

Friedrich’s ataxia Tracts affected?

Answer 6

Same as subacute combined degeneration of the spinal cord

1. Lateral corticospinal tracts
2. Dorsal columns
3. Spinocerebellar tracts

Question 7

Friedrich’s ataxia clinical notes?

Answer 7

Same as subacute combined degeneration of the spinal cord (see above)

In addition cerebellar ataxia → other features e.g. intention tremor

Question 8

Anterior spinal artery occlusion Tracts affected?

Answer 8

1. Lateral corticospinal tracts
2. Lateral spinothalamic tracts

Question 9

Anterior spinal artery occlusion: clinical notes?

Answer 9

1. Bilateral spastic paresis
2. Bilateral loss of pain and temperature sensation

Question 10

Syringomyelia: tracts affected?

Answer 10

1. Ventral horns
2. Lateral spinothalamic tract

Question 11

Syringomyelia: clinical notes?

Answer 11

1. Flacid paresis (typically affecting the intrinsic hand muscles)
2. Loss of pain and temperature sensation

Question 12

MS: tracts affected?

Answer 12

Asymmetrical, varying spinal tracts involved

Question 13

MS: clinical notes?

Answer 13

Combination of motor, sensory and ataxia symptoms

Question 14

Soley Sensory lesions?

Answer 14

Neurosyphilis (tabes dorsalis)

Question 15

Neurosyphilis (tabes dorsalis): tract affected?

Answer 15

1. Dorsal columns

Question 16

Neurosyphilis (tabes dorsalis): Clinical notes?

Answer 16

1. Loss of proprioception and vibration sensation