Spinal Cord Lesions

Question 1

ALS - Amyotrophic Lateral Sclerosis

Answer 1

UMN and LMN signs

Question 2

Spinal Cord Transection

Answer 2

1. Spinal Shock - LMN signs
2. UMN signs, loss of sensation, and loss of bowel/bladder/sexual functions below level of lesion.

• • Babinski sign is fist to appear

Note - bilateral Horner syndrome if lesion is at T1 or above.

Question 3

Brown-Sequard Syndrome/Hemisection

Answer 3

• ipsilateral loss of tactile/prop below lesion
• ipsilateral UMN signs below lesion
• ipsilateral LMN signs @ level of lesion
• CONTRALATERAL loss of pain/temp below lesion
• bilateral loss of pain/temp @ lesion

Question 4

Combined System Disease

Answer 4

vitamin B-12 deficiency -> bilateral degeneration of post. columns (esp fasciculus gracilis) and LCST in lumbosacral region

• bilateral loss of proprioception in LE
  
  • ataxic gait and + Romberg
• UMN signs in lower limbs

Question 5

Tabes Dorsalis (Tertiary Syphillis)

Answer 5

inflammation of lumbosacral DRG -> degeneration of fasciculus gracilis

• bilateral loss of tactile/prop in LE
  
  • ataxic gait, + Romberg sign
• hypotonia, loss of myotactic reflexes in LE
• insensitivity to pain in LE

Question 6

Syringomyelia

Answer 6

central canal expands to form cavity (syrinx), often associated with Chiari Malformation (syrinx in lower cervical levels) ​

1. bilateral & symmetrical loss of pain & thermal sense @ level of lesion (anterior white commissure)
2. expands and causes weakness w/ LMN signs (ventral horn), Horner syndrome, loss of tactile/prop (post columns)

Question 7

Anterior Spinal Artery Syndrome

Answer 7

ischemia of ALSTT, ventral horns, and LCST

1. Spinal Shock!
2. Development of

• bilateral UMN signs below level of lesion
• bilateral loss of pain & thermal sense below level of lesion
• Bilateral LMN signs (atrophy, etc) at level of lesion