Spinal Cord Pathologies Flashcards
(17 cards)
Progressive Spastic Paraparesis - Clinical features
Can be acute or subacute
- Bilateral weakness
- Marked Spasticity
- Affecting lower limbs
- Extensor plantar response
What are the causes of Progressive Spastic Paraparesis
- B12 deficiency (SACD)
- Copper deficiency
- Cervical Spondylotic myelopathy
- Hereditary
- MND
- Primary Progressive MS
What additional clinical features does PSP caused by B12 deficiency have
- Peripheral neuropathy
- Dorsal column dysfunction (high stepping gait)
What is the diagnostic investigation for Progressive Spastic Paraparesis
MRI
Transverse Myelitis - Clinical Features
- Similar to cord compression
- Acute weakness
- Ascending sensory level
What are some causes of Transverse myelitis
- Post infection
- Parainfectious complications (mycoplasma etc)
- First presentation of MS
What are the clinical features of anterior spinal artery thrombosis
- Flaccid paraparesis
- Loss of bladder function
- Preserved dorsal column
(fine touch, vibration, proprioception)
How do you manage anterior spinal artery thrombosis
- No treatment
- Recovery poor
Where are disc prolapses the most common
L4/L5 + L5/S1
What signs are associated with disc prolapse
- Reduced straight leg raised
- Diminished reflexes
Disc Prolapse - Management
Can require laminectomy
What is the pathophysiology of syringomyelia
- Cervical cord enlarges into large fluid-filled cavity
- Due to raised ICP causing mild herniation of tonsils
- Causes damage to local structures
What are the clinical features of syringomyelia + relate them to the structures damaged
Damage to spinothalamic tract
- loss of pain + temperature sensation
- acute, severe pain
Damage to corticospinal tract
- Spastic weakness
Damage to anterior horn cells
- muscle wasting
Syringomyelia - Investigations
MRI
Syringomyelia - Management
May require surgical drainage
What causes Spinal shock
- Transection of spinal cord at cervical/upper thoracic level
- Leads to loss of autonomic vasomotor control
What is the management of Spinal Shock
Substantial Fluid replacement
