Spinal cord lesions

Question 1

Motor (efferent) pathways

Answer 1

PYRAMIDAL
- corticospinal tract

EXTRA-PYRAMIDAL
- Rubrospinal
- Reticulospinal
- Vestibulospinal

Question 2

Sensory (afferent) pathways

Answer 2

Dorsal Column Medial Leminiscus
Spineocerebellar Tracts
Spinothalamic

Question 3

Motor Lesions

Answer 3

ALS MND
- affects UMN (corticospinal tracts) and LMN

Poliomyelitis
- affects anterior horns resulting in LMN signs

Question 4

Sensory Lesions

Answer 4

Neurosyphilis
- affects dorsal columns
=> loss of vibration/proprioception

Question 5

Give examples of combined Motor and Sensory lesions

Answer 5

1. Brown-Sequard syndrome (hemisection of cord)
2. Subacute combined degeneration of the spinal cord (vitamin B12 & E deficiency)
3. Friedrich’s ataxia
4. Anterior spinal artery occlusion
5. Syringomyelia
6. Multiple sclerosis

Question 6

Tracts affected in Brown-Sequard Syndrome

Answer 6

1. Lateral corticospinal tract
2. Dorsal columns
3. Lateral spinothalamic tract

Question 7

Tracts affected in Subacute combined degeneration of the cord and Friedrich’s ataxia

Answer 7

1. Lateral corticospinal tracts
2. Dorsal columns
3. Spinocerebellar tracts

Question 8

Tracts affected in Anterior spinal artery occlusion

Answer 8

1. Lateral corticospinal tracts
2. Lateral spinothalamic tracts

Question 9

Tracts affected in Syringomyelia

Answer 9

1. Ventral horns
2. Lateral spinothalamic tract

Question 10

What happens when the corticospinal tract(s) are affected?

Answer 10

Ipsilateral or bilateral spastic paresis below the level of the lesion

Question 11

What happens if the dorsal column(s) are affected?

Answer 11

Loss of proprioception and vibration sensation

Question 12

What occurs when the spinothalamic tract is affected?

Answer 12

loss of pain and temperature sensation

In Brown-Sequard this is on the CONTRALATERAL side, as the signals cross at the level of the lesion

Question 13

What happens if the spinocerebellar tracts are affected?

Answer 13

Bilateral limb ataxia

Question 14

What happens if the ventral horns are affected?

Answer 14

Flacid paresis
(typically affecting the intrinsic hand muscles)