Diseases of the Spinal Cord and Nerve Roots Flashcards Preview

Nervous System > Diseases of the Spinal Cord and Nerve Roots > Flashcards

Flashcards in Diseases of the Spinal Cord and Nerve Roots Deck (32):
1

what is Myelopathy?

any neurologic deficit related to the spinal cord

2

what is myelitis?

infection or inflammation of the spinal cord

3

what is Radiculopathy?

consequence of nerve root damage

4

what is radiculitis?

Inflammation of nerve root

5

what is myeloradiculopathy

Disease involving the spinal cord and nerve roots

6

what are the intrinsic causes of myelopathy or radiculopathy?

Inflammation
Infarction
Infiltration
Infection
Degenerative (neurones)

7

what are the extrinsic causes of myelopathy or radiculopathy?

Degenerative (spine)
Tumour
Extradural, intradural/extramedullary, intramedullary
Vascular abnormalities
Haemorrhage
AVM, dural fistula
Trauma

8

how do you treat extrinsic and intrinsic factors?

extrinsic-surgical
intrinsic-medical

9

what are upper motor neurone signs of disorders affecting the spinal cord or nerve roots

No wasting
↑tone
↑reflexes
Pyramidal pattern of weakness

10

what are lower motor neurone signs of disorders affecting the spinal cord or nerve roots

wasting
↓tone
↓reflexes
weakness

11

what are sensory signs of radiculopathy

dermatomal pattern of sensory loss

12

what does laminated tracts refer to?

any external pressure exerted on spinal cord in region of spinothalamic tracts will first experience a loss of pain and temp sensation in the sacral dermatome of the body

13

name the ipislateral spinal tracts

UMN- Corticospinal
Dorsal columns

14

name the contralateral spinal tracts

spinothalamic also called your ventrolateral/anterolateral tract

15

what would be the signs of a c5 cord lesion?

Wasting of C5 innervated muscles
↑ tone in LL>UL
Reflexes ↓biceps, ↑all lower reflexes
Power ↓C5 innervated muscles, pyramidal pattern below
Sensory level

16

give some medical causes of myelopathy

Demyelination (MS)
Ischaemic
Transverse Myelitis
Metabolic, B12 deficiency

17

where is a stroke most likely to occur on the spinal cord?

Thoracic cord and very bottom of cord have poor blood supply- most likely to get stroke

18

what are causes of spinal cord ischaemia?

Anything that can throw off a clot/make blood slow or sticky:
Atheromatous disease
Thromboembolic disease
Arterial dissection
Systemic hypotension
Hyperviscosity
Vasculitis

19

what is the clinical presentation of spinal cord stroke?

May have vascular risk factors
Onset may be sudden or over several hours
Pain:
-Back pain/radicular
-Visceral referred pain
Weakness-usually paraparesis
Numbness and paraesthesia
Urinary symptoms
Retention followed by bladder and bowel incontinence as spinal shock settles

20

which artery is usually affected in spinal cord stroke?

Usually anterior spinal artery
Very rarely posterior spinal artery => dorsal columns spared

21

Occlusion of which artery can present as a partial Brown-Séquard syndrome?

central sulcal artery

22

what is the difference between T1 & T2 MRI?

T1-looks at structure(CSF black)
T2-looks at pathology(CSF white)

23

what is the treatment of spinal cord stroke?

Supportive
Reduce risk of recurrence:
-Maintain adequate BP
-Bed rest
-Reverse hypovolaemia/arrhythmia
OT and physiotherapy
Manage vascular risk factors

24

what is the prognosis of spinal cord stroke?

Unless significant motor recovery in first 24 hours chance of major recovery is low
Pain may be persistent
20% mortality, only 35-40% have more than minimal recovery

25

when does demyelinating Myelitis occur?

Usually part of MS
Common cause of medical spinal cord disease
Can affect the young

26

what characterises myelitis: multiple sclerosis?

pathological lesions of inflammation and demyelination leading to temporary neuronal dysfunction
Affects the white matter of the CNS
One or more lesions anywhere

27

describe demyelination myelitis of MS

Partial or incomplete transverse myelitis
May be the initial presentation of MS
Subacute onset (slower than ischaemia)
may be history of previous neurological or ophthalmological episodes

28

what is the treatment of MS myelitis?

Supportive
Methylprednisolone

29

what are the causes of transverse myelitis?

Idiopathic
Viral:
VZV, HSV, CMV, EBV, influenza, echo virus, HIV, hepA, rubella
Other infections:
Syphilis, measles, Lyme
Autoimmune:
SLE, sjögren’s syndrome, sarcoidosis
Malignancies
Post vaccination:
Chicken pox, rabies

30

what is Pernicious anaemia?

Autoimmune condition in which antibodies to IF prevent B12 absorption

31

how does B12 deficiency affect the nervous system?

Myelopathy-L’hermitte’s
Peripheral neuropathy
(Brain, Eye/optic nerves, Brainstem, cerebellum)

32

what are the symptoms of B12 deficient myelopathy?

Paraesthesia hands and feet, areflexia
First UMN sign ↑plantars
Degeneration of :
-corticospinal tracts→paraplegia
-Dorsal columns→sensory ataxia
Painless retention of urine