08 Spinal Cord Syndromes

Polio

.,

Werdnig-hoffman disease

.,

• similar to polio without virus

MS

.,

• symptoms in one region of body, go away and come back in another region

ALS

.,

• both lower/upper lost

• progressive dysphagia until feeding tube, can't clear aspirations

• free radical scavenger enzyme

ASA Occlusion

The ASA is particularly dependent on blood supply from the radicular arteries that originate from the thoracic aorta, such as the artery of Adamkiewicz. Thoracic aortic surgery can result in reduced blood flow through the radicular arteries (eg, from aortic cross-clamping and/or systemic hypotension) and consequently lead to anterior spinal cord infarction.

Tabes Dorsalis

.,

• lose proprioception/balance: ataxic

• also lose dorsal roots: lose reflexes

Syringomyelia

.,

• Central cord syndrome (CCS) typically occurs with hyperextension injuries in elderly patients with pre-existing degenerative changes in the cervical spine.

• Can also be from whiplash injury from MVA

Subacute Combined Degeneration

.,

• Tabes Dorsalis plus UMN symptoms

Brown Sequard

.,

• complete sensory loss

Cauda Equina

• normal babinski because nerves in cauda equina are LMN, not UMN

Conus Medullaris

Overview

Disease	Location	Symptoms
Polio	ventral horn	loss reflex, LMN signs
MS	Varies	Varies
ALS	corticospinal, ventral horn	UMN/LMN
ASA Occlusion	all spinal cord, no DCML	LMN signs, DCML intact
Syphillis	DCML, dorsal root	loss reflex, gait, +Romberg, pupil, strength intact
Syringomyelia	White commissure	Pain/temp bilateral
B12 deficiency	DCML, corticospinal	UMN, ataxia,
Brown Sequard
Cauda Equina		LMN signs, saddle anesthesia
Conus Medullaris		UMN, saddle anesthesia, impotence