spinal cord lesions Flashcards Preview

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Flashcards in spinal cord lesions Deck (22):
1

diseases that affect motor neurons in anterior horn (LMN diseases)

poliovirus
west nile virus
spinal muscular atrophy (Werdnig Hoffman disease)

2

AR disease
neuron death in anterior horn of spinal cord
infant: flaccid paralysis, die

spinal muscular atrophy (Werdnig Hoffman disease)

3

disease affects oligodendroglia (CNS) →
demyelination of CNS (no saltatory conduction) →
random and symmetric lesions in white matter of spinal cord + brainstem + brain
`

multiple sclerosis

4

autoimmune disease
more common in women 20-30 yo
charcot's triad:
scanning speech
intention tremor
nystagmus
may also have:
internuclear opthalmoplegia (lesion to MLF) - paralysis of adducting eye + nystagmus of abducting eye on attempted lateral gaze
bowel/bladder incontinence
optic neuritis

multiple sclerosis

5

CSF of poliovirus

lymphocytic pleocytosis
N/slight elevation of protein

6

CSF of multiple sclerosis

very HIGH elevation of protein (immunoglobulin light chains = oligoclonal bands on electrophoresis)

7

diagnosis of MS

lesions of brain + spinal cord

8

treatment of MS

severe exacerbation: high dose steroids for 1 week
IFN-B
natalizumab
if bladder incontinence/neurogenic bladder: catheter
spastistity (no UMN): muscular relaxer
pain: opioids

9

disease that affects motor neurons of anterior horn (LMN) + lateral corticospinal tracts (UMN)

amyotrophic lateral sclerosis (ALS)

10

LMN signs + UMN signs (no sensory deficit)
rapidly progressive weakness
muscle atrophy
fasiculations
spasticity
difficulty speaking (dysarthria)
difficulty swallowing (dysphagia)
difficulty breathing (dyspnea)

amyotrophic lateral sclerosis (ALS)

11

defect in superoxide dismutase 1

amyotrophic lateral sclerosis (ALS)

12

treatment of ALS

↑ survival time: Riluzole: ↓ presynaptic glutamate release since neurotoxic at high doses

13

3° syphilis causes

tabes dorsalis

14

disease with no dorsal columns: no light touch + proprioception
+ Romberg sign (need 2 of 3 variables to maintain balance - no visual + proprioception)
argyll robertson pupil
absent DTR
sensory ataxia at night: broad-gait

tabes dorsalis (3° syphilis)

15

Argyll Robertson pupil

pupil accommodates but doesn't react to light (3° syphilis - tabes dorsalis)

16

loss of pain + temp sensation (spinothalamic)
loss of bilateral motor command: corticospinal tracts (UMN signs) + anterior horns (LMN signs)
BELOW lesion: complete motor paralysis, loss of pain + temp, areflexia

anterior spinal artery lesion (only spares dorsal columns + Lissauer's tracts - light pressure, touch, vibration)

17

cause of anterior spinal artery lesion

aortic aneurysm
aortic dissection
direct trauma to aorta
atherosclerosis

18

cyst (syrinx) or cavity within spinal cord
usually between C2-T9

syringomyelia

19

associated with Chiari malformation I

syringomyelia

20

most commonly affects: C2-T9
damage to anterior white commisure + spinothalamic tracts
+/- chronic pain
may lose sensations in hands

syringomyelia
dorsal columns: fine touch proprioception spared

21

complete hemisection of spinal cord:
below lesion:
ipsilateral UMN signs (no corticospinal tract)
ipsilateral loss of tactile, vibration, proprioception (no dorsal columns)
CONTRALATERAL loss of pain + temperature 2-3 (no corticospinal tracts) segments BELOW lesion
At lesion:
ISPILATERAL pain + temp loss for 2-3 segments (no Lissauer tract)
ipsilateral LMN signs (no anterior horn)

brown-sequard syndrome

22

CSF of Guillain-Barre syndrome

↑ protein
normal cell count

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