Where's the lesion Flashcards
What is degenerative cervical myelopathy
spinal cord dysfunction from compression in the neck
Risk factors of degenerative cervical myelopathy
- smoking - impact on IVD
- genetics
- Occupation: if high axial loading
Symptoms of Degenerative cervical myelopathy
- Pain in neck, upper or lower limbs
- Loss of motor function: fine dexterity first
- Loss of sensory function: numbness
- Loss of autonomic function: urinary or faecal incontinence
Gold standard investigation for Degenerative cervical myelopathy
MRI
Findings on MRI in Degenerative cervical myelopathy
- disc degeneration
- ligament hypertrophy
- cord signal change
Management of Degenerative cervical myelopathy
- Urgent referral to neurosurgery or spinal orthopaedic surgeon
- Early spinal decompressive surgery within 6 months of diagnoses to prevent permanent spinal cord damage
- Mild stable disease can be managed with close observation
What is peripheral neuropathy
Damage to the nerves outside the brain and spinal cord leading to pain, weakness and sensory deficits
Examples of predominantly motor peripheral neuropathy
- Guillain-Barre syndrome
- porphyria
- lead poisoning
- hereditary sensorimotor neuropathies (HSMN) - Charcot-Marie-Tooth
- chronic inflammatory demyelinating polyneuropathy (CIDP)
- diphtheria
Examples of predominantly sensory peripheral neuropathy
diabetes uraemia leprosy alcoholism vitamin B12 deficiency amyloidosis
What is alcoholic neuropathy
- secondary to both direct toxic effects and reduced absorption of B vitamins
- sensory symptoms typically present prior to motor symptoms
Why does vitamin B12 lead to a peripheral neuropathy
- subacute combined degeneration of spinal cord
- dorsal column usually affected first (joint position, vibration) prior to distal paraesthesia
Contents of cavernous Sinus
Oculomotor nerve Trochlear nerve Ophthalmic nerve Maxillary nerve Internal carotid artery (and sympathetic plexus) Abducens nerve
