Spinal cord syndromes Flashcards
SACD causes
Vitamin B12 deficiency, VitE deficiency, Cu deficiency
NO intoxication
Masses causing Spinal cord compression
Intramedullary - gliomas, medulloblastomas, etc
Extradural -spinal mets, tumours of surrounding tissues
Intradural/extramedullary -meningeal mets, neurofibroma,meningioma
First symptom of spinal mets
Axial pain>radicular pain >neurological deficits
Important sign of spinal mets
Spinal tenderness
Clinical patterns of meningeal cancer
- Encephalopathy(less common) -headache, drowsiness, confusion, papilledema
- Multifocal lesions - nerve roots, cranial nerves, spinal cord
Causes of acute myelopathy
Demyelination, infection, inflammation (NMO), vascular, neoplastic, Compression/surgical causes
L5 vs common peroneal nerve
Weakness of hip abduction and foot inversion -L5
Amyotropic lateral sclerosis features
Most common form
UMN and LMN signs
Limbs and bulbar involvement
Primary lateral sclerosis
Pure UMN
Rare -2-3%
Slow rate of progression
Progressive muscular atrophy
Pure LMN
Older males
Improved survival -48months
Progressive bulbar palsy
Presents with bulbar symptoms Most commonly in post menopausal women Worst prognosis Lower cervicothoracic to lumbosacral area Rarely confined to bulbar only
Flail arm syndrome
Symmetric proximal and distal bi brachial wasting+positive babinski
M:F -9:1
Signs that are absent in MND
Sensory symptoms
Bowel and bladder
Ocular palsy
Cognitive dysfunction in MND
Present in 30-50% of patients with MND
Mostly frontotemporal dementia
Pathologically:
Neuronal loss in brain stem nuclei and anterior horn cells+corticospinal tract degeneration
Ubiquitin positive inclusion in LMN, TDP-43
Genetic factors important
Genes in familial MND
C9orf 72(most), SOD1,FUS, TDP-43
