Neurological syndrome/stroke presentations

Question 1

Bowel control and spinal cord injuries?

Answer 1

If spinal cord injury is above T-12 level, the ability to
feel when the rectum is full is lost

The anal sphincter muscle remains tight

Bowel movements occur on a reflex basis –> when the rectum is full, the defecation reflex occurs, emptying the bowel

Question 2

Bladder control and spinal cord injuries?

Answer 2

Injury above T12 –> neurogenic bladder (spastic, reflex)

Below T12 –> atonic /flaccid bladder

Question 3

What findings are present in the first week post spinal cord injury?

Answer 3

Spinal shock = flaccid weakness, unreactive plantars

> 1 week = development of spastic quadriplegia and Babinski (connected with spastic muscle tone)

Question 4

What voluntary motor function is left with a C3-6 injury?

Answer 4

Voluntary movement in:

• Diaphragm
• Triceps

No grip strength
Requires stabilization to sit

Question 5

What voluntary motor function is left with a C5-8 injury?

Answer 5

Diaphragm
Triceps
Wrist and hand movements

Requires stabilization to sit

Question 6

What voluntary motor function is left with a T1-T5 injury?

Answer 6

Some upper extremity and back muscles
Hand muscles
Minimal abdominal muscle control

May require stabilization to sit

Question 7

What voluntary motor function is left with a T6-T10 injury?

Answer 7

All upper extremity and back muscles
Upper abdominal muscles

Don’t require stabilization to sit

Question 8

What voluntary motor function is left with a T11-T12 injury?

Answer 8

Normal spinal and abdominal muscle function

Some hip flexion and adductor function

Question 9

What voluntary motor function is left with a L1-S2 injury?

Answer 9

Some lower limb function - may be able to walk with aids

Question 10

What parasympathetic control do the cranial nerves have over the body?

Answer 10

Vagus nerve - heart and GIT

Question 11

What parasympathetic control arises in T1-L5?

Answer 11

Cardiovascular
Lungs
GIT
Kidneys
Sweat glands

Question 12

What parasympathetic control from L5-S2?

Answer 12

Bladder and bowel control

Question 13

Feature differentiating cerebellar stoke from acute vestibular neuritis?

Answer 13

Horizontal-torsion gaze that suppresses with visual fixation

Peripheral cause of nystagmus is only unilateral
Central = bidirectional or up and down and skew changes

Question 14

Common problem with recovery from Bell’s palsy?

Answer 14

Aberrant regeneration of the facial nerve

Mouth and eyes usually - volunatry movement –> involuntary movement
Salivation and tearing

Question 15

Finding most specific of Bell’s palsy?

Answer 15

Loss of taste

Question 16

Treatment for Bell’s Palsy?

Answer 16

Steroids