Diseases of the Spinal Cord and Nerve Roots Flashcards Preview

Neurology > Diseases of the Spinal Cord and Nerve Roots > Flashcards

Flashcards in Diseases of the Spinal Cord and Nerve Roots Deck (13)
Loading flashcards...
1
Q

What are the upper motor neurone signs of cord/root pathologies?

A

No wasting
Increased tone
Increased reflexes, extensor plantar
Pyramidal pattern of weakness

2
Q

What are the lower motor neurone signs of cord/root pathologies?

A

Decreased tone
Decreased reflexes, flexor plantar
Weakness

3
Q

What are the signs of C5 cord lesions?

A

Wasting of C5 innervated muscles
Tone more increased in arms than in legs
Reflexes decreased in biceps but increased in all lower reflexes
Decreased power in all C5 innervated muscles

4
Q

What are the causes of myelopathy?

A

Congenital- Friedrich’s ataxia, spinocerebellar ataxias, hereditary parapresis
Acquired- inflammation, vascular, infective, metabolic (B12 deficiency), malignant, idiopathic, trauma, surgical

5
Q

What are the causes of spinal cord ischaemia?

A
Atheromatous disease
Thromboembolic disease
Arterial dissection
Systemic hypotension
Thrombotic haematological disease
Hyperviscosity syndromes
Vasculitis
Venous occlusion
Endovascular procedures
Decompression sickness
Meningovascular syphilis
6
Q

How does a spinal cord stroke present?

A

Onset can be sudden or over several hours
Pain- Back pain with possible referred visceral pain
Weakness- usually paraparesis
Numbness and paraesthesia
Urinary symptoms (retention followed by incontinence)

7
Q

Which artery is most commonly causative of a spinal cord stroke?

A

Anterior spinal artery

8
Q

Describe the management of a spinal cord stroke

A

Reduce risk of recurrence- maintain adequate BP, reverse hypovolaemia/arrhythmia, anti-platelet therapy
OTs and physiotherapy
Manage vascular risk factors

9
Q

What does the return of function after a spinal cord stroke depend on?

A

The degree of parenchymal damage

10
Q

What dietary components is vitamin B12 abundant in?

A

Meat, fish and most animal by-products

Legumes

11
Q

How does B12 deficient myelopathy present?

A

Paraesthesia and areflexia in hands and feet
First UMN sign- extensor plantars
Degeneration of corticospinal tracts causes paraplegia, dorsal columns causes sensory ataxia
Painless retention of urine

12
Q

What investigations can be useful in B12 deficient myelopathy?

A

FBC/Blood film

B12 levels

13
Q

How is B12 deficient myelopathy treated?

A

Intramuscular B12