Spinal Cord Lesions

Question 1

A patient that has muscle atrophy, negative babinski, downgoing toes, fasciculations and flaccid paralysis in adults; hypotonia?

Answer 1

Poliomyelitis

Question 2

A patient that has muscle atrophy, negative babinski, downgoing toes, fasciculations and flaccid paralysis in infants? What kind of baby do you get? Inheritance

Answer 2

Spinal muscular atrophy

Floppy baby

AR

Question 3

A patient with polio with show what in CSF? also where would you recover the virus?

Answer 3

High WBC and protein but normal CSF glucose

Fecal-Oral transmission

Question 4

Scanning Speech, Intention Tremor and nystagmus?

Answer 4

MS

Question 5

Polio affects?

Answer 5

Anterior Horn

Question 6

MS affects?

Answer 6

Part of DCML and spinothalamic

Question 7

Both muscle atrophy, negative babinski, downgoing toes, fasciculations and flaccid paralysis in adults; hypotonia AND Hypertonia hyperrflexia?

Answer 7

ALS

Question 8

ALS is caused by?

Answer 8

Superoxide dismutase I

Question 9

ALS Tx? Which one has shown to be the only one with survival?

Answer 9

Rilouzole

Question 10

Rilouzole MOA?

Answer 10

MOA: glutamate antagonist

Question 11

What does Superoxide Dismutase do?

Answer 11

Converts O2 to H2O2

Question 12

Patient’s pain temperature and motor skills are gone and only has fine touch sensory and proprioception left. Dx? Which spinal cord does it most likely affect and why?

Answer 12

Complete occlusion of anterior spinal artery

T4, Upper thoracic ASA is watershed area because the artery of adam only supplies up to T8

Question 13

Patient loses ability of proprioception and progressive sensory ataxia. +Romberg Test and absence of DTRs. Dx and what is it associated with?

Answer 13

Tertiary Syphilis (Tertiary Syphilis)

Associated with:

1. Charcot joints
2. Argyll Robertson Pupils (accommodates but does not constrict to light)

Question 14

Patient has bilateral loss of pain and teperature sensation at C8-T1. Dx? Why does this occur? What is it associated with?

Answer 14

Dx: Syringomyelia
Reason: Cystic cavity within the spinal cord
Associated with: Chiari

Question 15

Demyelination of dorsal columns, lateral corticospinal tracts and spinocerebellar tracts and ataxic gait?

Answer 15

Subacute combined degeneration by Vitamin B12 deficiency

Question 16

A patient who has frequent falling, nystagmus, High arched foot, hammer toes with kyphoscoliosis (Ataxia+multiple spinal cord tracts)? Dx? Cause of Death? Gene? and what does the gene do?

Answer 16

Dx: Friedreich Ataxia=GAA on chromosome 9 in frataxin gene

Cause of Death: Hypertrophic cardiomyopathy

Frataxin=>iron storage regulation

Question 17

A patient with loss of all sensation at the level of lesion and Motor on the same side and loss of temperature and pain on the opposite side?

Answer 17

Brown-Sequard Syndrome

Question 18

Bilateral loss of pain and decreased muscle strength?

Answer 18

Syringomyelia

Question 19

What is wrong in Friedreich Ataxia?

Answer 19

Spinocerebellar tract