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SpinalCord Lesions

Quick comparison: Spinal cord lesions

Anterior spinal artery occlusion
  • bilateral spastic paresis and loss of pain and temperature sensation
Subacute combined degeneration of the spinal cord
  • bilateral spastic paresis, loss of proprioception and vibration sensation and limb ataxia

Spinal cord lesions

The diagram belows shows cross-section view of the spinal cord:

Image sourced from Wikipedia

Motor lesions

Amyotrophic lateral sclerosis (motor neuron disease)

  • affects both upper (corticospinal tracts) and lower motor neurons
  • results in a combination of upper and lower motor neuron signs

Poliomyelitis

  • affects anterior horns resulting in lower motor neuron signs

Combined motor and sensory lesions

Disorder Tracts affected Clinical notes
Brown-Sequard syndrome (spinal cord hemisection) 1. Lateral corticospinal tract 2.Dorsal columns 3. Lateral spinothalamic tract 1. Ipsilateral spastic paresis below lesion
2. Ipsilateral loss of proprioception and vibration sensation
3. Contralateral loss of pain and temperature sensation
Subacute combined degeneration of the spinal cord (vitamin B12 & E deficiency) 1. Lateral corticospinal tracts
2. Dorsal columns
3. Spinocerebellar tracts 1. Bilateral spastic paresis
2. Bilateral loss of proprioception and vibration sensation
3. Bilateral limb ataxia
Friedrich's ataxia Same as subacute combined degeneration of the spinal cord (see above) Same as subacute combined degeneration of the spinal cord (see above)

In addition cerebellar ataxia → other features e.g. intention tremor | | Anterior spinal artery occlusion | 1. Lateral corticospinal tracts
2. Lateral spinothalamic tracts | 1. Bilateral spastic paresis
2. Bilateral loss of pain and temperature sensation | | Syringomyelia | 1. Ventral horns
2. Lateral spinothalamic tract | 1. Flacid paresis (typically affecting the intrinsic hand muscles)
2. Loss of pain and temperature sensation | | Multiple sclerosis | Asymmetrical, varying spinal tracts involved | Combination of motor, sensory and ataxia symptoms |

Sensory lesions

Disorder Tracts affected Clinical notes
Neurosyphilis (tabes dorsalis) 1. Dorsal columns 1. Loss of proprioception and vibration sensation