L10 - Spinal Cord Integration

What vertebral levels and structures are affected in Conus Medullaris Syndrome?

Conus Medullaris Syndrome involves compression at T12–L2 vertebral levels, affecting the conus medullaris and exiting nerve rootlets.

What are the motor and sensory signs seen in Conus Medullaris Syndrome?

It presents with bilateral upper and lower motor neuron deficits and sensory loss in the lumbar and sacral regions, including saddle anesthesia.

What autonomic symptoms are associated with Conus Medullaris Syndrome?

Patients may experience bowel and bladder control issues and sexual dysfunction.

What type of back pain is associated with Conus Medullaris Syndrome?

Low back pain is a common presenting symptom.

What part of the nervous system is affected in Cauda Equina Syndrome, and what causes it?

Cauda Equina Syndrome involves damage to the lumbar and sacral nerve roots, without affecting the spinal cord itself.

What motor and sensory signs are present in Cauda Equina Syndrome?

It causes lower motor neuron signs, sensory loss in all modalities including saddle anesthesia, and possibly asymmetric motor and sensory deficits.

What autonomic issues occur in Cauda Equina Syndrome?

There may be bowel and bladder dysfunction and sexual dysfunction.

What kind of pain is typically reported in Cauda Equina Syndrome?

Patients often report low back pain.

What areas of the spinal cord are supplied by the Anterior Spinal Artery?

The Anterior Spinal Artery supplies the anterior and lateral white matter tracts, anterior horns of gray matter, and the anterior white commissure.

What neurological deficits are caused by Anterior Spinal Artery Occlusion?

It leads to motor loss and loss of pain and temperature sensation, while sparing dorsal column functions like proprioception and vibration.

How common is Posterior Spinal Artery stroke compared to Anterior?

Posterior spinal artery stroke is rare, comprising only 1–2% of ischemic strokes.

What is another name for Anterior Spinal Artery Occlusion?

It is also referred to as spinal cord stroke.

What causes Acute Poliomyelitis and which neurons are targeted?

Acute Poliomyelitis is caused by an RNA enterovirus that replicates in and destroys spinal motor neurons.

What are the neurological effects of Acute Poliomyelitis?

It causes lower motor neuron signs such as flaccid paralysis, hyporeflexia, and muscle atrophy.

Are cranial nerves affected in Acute Poliomyelitis?

Cranial motor nerves may be affected, but less commonly than spinal motor neurons.

What is Post-Polio Syndrome?

It is a recurrence of muscle weakness in areas previously affected by poliomyelitis.

What is Tabes Dorsalis and what causes it?

Tabes Dorsalis is a form of tertiary syphilis that damages the dorsal roots and causes dorsal column atrophy.

What sensory deficits are found in Tabes Dorsalis?

It leads to loss of discriminative touch and proprioception, causing functional mobility issues.

What unusual pains are experienced in Tabes Dorsalis?

Patients may experience paresthesias, especially 'lightning pains'.

What clinical sign suggests a dorsal column lesion in Tabes Dorsalis?

Lhermitte’s sign—an electric shock sensation down the back/limbs when the neck is flexed—suggests dorsal column damage.

What is Syringomyelia and where is it commonly located?

Syringomyelia is a fluid-filled cavity (syrinx) in the central spinal cord, most often in the cervical region.

What sensory deficits are typical of Syringomyelia?

It causes bilateral loss of pain and temperature sensation, typically in a cape-like distribution over the shoulders and arms.

What spinal structure is initially affected in Syringomyelia?

The anterior white commissure is usually the first affected area.

What motor symptoms can occur if Syringomyelia progresses?

If the syrinx enlarges, it may involve ventral horns and lead to motor weakness.

What causes Central Cord Syndrome and who is most at risk?

It is typically caused by traumatic cervical spine injury in older individuals.

What is the initial site of damage in Central Cord Syndrome?

The damage starts centrally and affects the anterior white commissure and ventral horn.

Which limbs are more severely affected in Central Cord Syndrome?

The upper limbs, especially the hands, are more impaired than the lower limbs.

What is sacral sparing in the context of Central Cord Syndrome?

Sacral sparing refers to retained sacral motor and sensory function due to peripheral location of sacral fibers in spinal tracts.

What is Amyotrophic Lateral Sclerosis (ALS) and what neurons are affected?

ALS is a progressive disease of unknown origin that affects both upper motor neurons in the precentral gyrus and lower motor neurons in the spinal cord and brainstem.

What motor signs are seen in ALS?

It presents with a combination of upper and lower motor neuron signs, such as spasticity, weakness, and atrophy.

What is a common early symptom of ALS?

Spasticity is often prominent early in the disease.

What is the prognosis of ALS?

ALS is a progressive and ultimately fatal disease.

What are common causes of Axonal Neuropathies?

Causes include diabetes mellitus, vitamin B12 deficiency, HIV, and Lyme disease.

Which axons are affected first in Axonal Neuropathies?

The longest axons are affected first, leading to distal-to-proximal progression of symptoms.

What is the characteristic sensory pattern in Axonal Neuropathies?

Stocking-glove sensory loss, with symptoms appearing in the feet first and progressing to the hands only after reaching the knees.

Do patients with Axonal Neuropathies initially feel symptoms in their hands?

No, hand symptoms typically appear only after the sensory loss reaches the knees.