Week 1 NDx: Summary of Lesions

Damage to half of spinal cord is what kind of lesion

Brown-Sequard Syndrome (Hemisection lesion)

Brown-Sequard syndrome symptoms include _________ loss of pain and temperature sensation and _______ loss of motor function, proprioception and discriminatory touch

Contralateral; ipsilateral

- ipsilateral LCST deficits

- contralateral STT deficits

What syndrome causes loss of function in upper extremities caused by injury to the middle portion of the spinal cord

Central cord syndrome

What causes central cord syndrome

Progressive stenosis or compression that is a consequence of hyperextension injuries

Central cord syndrome symptoms include _______ loss of pain, temperature and light touch ONLY at the level of injury

Bilateral

What kind of lesion is characterized by a cyst in the central canal thats often associated with the cervical cord and can be found in combination with Arnold-Chiari malformation?

Syringomyelia

Symptoms of Syringomyelia (expansion of the canal) results in ________ segmental losses of the crossing fibers of the STT causing a "cowl-like" loss of pain and temperature sensations

Bilateral

If the the lesion with Syringomyelia is longer than just one segment, bilateral _____ and _______ paresthesia could occur

Arm; glove

Syringomyelia has very similar symptoms to what other lesion

Central cord syndrome

This lesion is caused by the occlusion of, or damage to the anterior spinal artery

Anterior cord syndrome

The anterior spinal artery perfuses the entire cord (anterior 2/3) BILATERALLY except the ______ white columns

Posterior

Anterior cord syndrome symptoms include complete ______ loss of motor, pain and temperature sensation below the lesion, but two point discrimination, fine touch and conscious proprioception are ______

Bilateral; spared

This lesion is caused by a tumor, damage to the posterior spinal artery, trauma or MS

Posterior cord syndrome

The anterior spinal artery supplies the anterior ___/___ of the cord and the posterior spinal artery supplies the posterior ____/____ of the cord

2/3; 1/3

Posterior cord syndrome symptoms include ______ loss of light touch, vibration and position sense below the lesion level

Bilateral

Anterior cord syndrome involves everything but the _____ _____ column and posterior cord syndrome involves only the _____ ____ column

Dorsal white

This type of lesion is a result of the tertiary manifestation of syphilis that involves the destruction of the dorsal white columns, most prominently being the fasciculus gracilis

Tabes dorsalis

What test is positive with tabes dorsalis, which involves loss of conscious proprioception

Rhomberg

Tabes dorsalis involves _____ ataxia

Sensory

Tabes dorsalis needs to be considered as DDx of what other syndrome

Posterior cord syndrome

________ lesions (ALS / syringomyelia) will typically produce upper extremity weakness that gradually descends to the trunk and lower extremity

Expansive

___________ lesions will typically produce an ascending

pattern of motor weakness

Compressive

A condition of progressive deterioration of motor nerve cells resulting in total loss of voluntary muscle control; both CST and GSE neurons are destroyed

Amyotrophic Lateral Sclerosis (ALS)

Another name for ALS

Lou Gehrig's disease

ALS symptoms include MOTOR weakness of the LE first, followed by UE. Fasciculations often occur due to loss of LMN, with the _____ often being affected. Swelling and speech can be affected if the condition begins in the brainstem.

Tongue

A chronic disease of the central nervous system marked by CNS axon demyelination

Multiple sclerosis

MS affects both _____ and _____ systems

Motor and sensory

In the cord, the prominent myelinated axons may be affected: dorsal white columns, corticospinal tracts, spinocerebellar tracts. Leading to _______ ataxia

Cerebellar

ALS exhibits only ______ findings whereas MS exhibits _____ and ____ findings

Motor; motor and sensory

A neurologic disorder caused by vitamin B12 deficiency that leads to demyelination of both the dorsal columns and lateral corticospinal tracts of the spinal cord, resulting in a combination of sensory loss (proprioception/vibration), ataxia, and upper motor neuron signs.

Subacute combined degeneration (SCD)

With subacute combined degeneration, _______ will occur in both the CNS and PNS

demyelination

subacute combined degeneration causes both motor and sensory problems and therefore should be compared to what other condition

Multiple sclerosis

What syndrome is an acute autoimmune disorder in which the immune system demyelinates peripheral nerves, causing rapidly progressive, symmetric muscle weakness and areflexia, often beginning in the legs and sometimes leading to respiratory failure.

Guillain-Barré Syndrome