spinal cord syndromes Flashcards
common causes of spinal cord lesions
- trauma (most common)
- degenerative diseases
- inflammatory diseases
- tumors
- infections
examples of trauma that causes spinal cord lesions
accidents
falls
sports
injuries
examples of degenerative diseases that causes spinal cord lesions
spinal stenosis
herniated disc
examples of inflammatory diseases that causes spinal cord lesions
multiple sclerosis
clinical manifestations of spinal cord lesions
- motor deficits
- sensory deficits
- autonomic dysfunction
examples of motor deficits (what they cause)
- paraplegia (2 limb paralysis)
- quadriplegia (4 limb paralysis)
- muscle weakness and atrophy
examples of sensory deficits
- loss of sensation below the lesion
- abnormal sensations (paraesthesia, neuropathic pain)
examples of autonomic dysfunction
- bladder and bowel control issues
- blood pressure regulation problems
selected spinal cord syndromes (not the most common but most illustrated - easier to see and understand)
- syringomyelia
- amyotrophic lateral sclerosis
- subacute combined degeneration
- brown-sequard syndrome
signs and symptoms of syringomyelia?
loss of pain and temperature sensation
- bilateral in the arms
- cape-like distribution over shoulders and arms (usually)
what is amyotrophic lateral sclerosis (ALS) and its symptoms?
- degeneration of motor neurons in spinal cord and brainstem (cranial nerves)
- progressive weakness and wasting of skeletal muscles (muscle atrophy)
- death usually within 5 years of onset
- sensation and other functions are normal
lou gherig
“luckiest man on the face of the earth”
- the baseball player who was known as one of the earliest cases of ALS
what is subacute combined degeneration
degeneration of dorsal columns and lateral columns in spinal cord due to demyelination
what signs and symptoms are noted in patients with combined systems disease?
- loss of vibration sense, joint position sense
- vitamin B12 deficiency (pernicious anemia)
- paresthesias (pins and needles)
- weakness of limbs
- mental signs (loss of acuity, cortical function)
Brown-Sequard Syndrome signs and symptoms?
- ipsilateral paralysis
- ipsilateral loss of fine touch and joint position sense
- contralateral loss of pain and temperature
dermatome
- area of skin innervated by one spinal nerve
- each one can be traced to a specific nerve root
- dorsal root = sensory
- if you cut one, there will be a section that follows the root that loses sensation
how many pairs of dermatomes from the skull to the toes?
30 pairs
shingles
- are an example of dermatome
- caused by herpes zoster and produces chicken pox
- inhabits CNS
what is syringomyelia?
- an opening of the spinal cord
cause of syringomyelia
an infection that expands and grow
where does the lesion occur for syringomyelia?
- in the cervicospinal cord (center of grey matter)
- makes spinal canal very visible
when looking at the stain, what signifies ALS?
- the demyelination of white matter in dorsal and ventral parts
- impacts dorsal columns and anteriocorticospinal tract
what does subacute combined degeneration affect?
- causes B12 deficiency
- pernicious anemia (autoimmune disease for B12 deficiency)
- affect corticospinal tract, fasciculus gracilis and cuneatus
is subacute combined degeneration treatable?
YES
what is Brown- Sequard syndrome
half spinal cord severance
= hemisected spinal cord
symptoms of shingles?
- blisters
- rash
- pain
what happens with shingles?
- herpes zoster produces chicken pox
- virus goes to DRG and lies dormant
- reactivated in older age causing shingles
