neurologic disorders
Spinal Cord Compression
Symptoms and Signs of Spinal Cord Compression
Acute or advanced spinal cord compression causes segmental deficits, paraparesis or quadriparesis, hyporeflexia (when acute) followed by hyperreflexia, extensor plantar responses, loss of sphincter tone (with bowel and bladder dysfunction), and sensory deficits. Subacute or chronic compression may begin with local back pain, often radiating down the distribution of a nerve root (radicular pain), and sometimes hyperreflexia and loss of sensation. Sensory loss may begin in the sacral segments. Complete loss of function may follow suddenly and unpredictably, possibly resulting from secondary spinal cord infarction. Spinal percussion tenderness is prominent if the cause is metastatic carcinoma, abscess, or hematoma. Intramedullary lesions tend to cause poorly localized burning pain rather than radicular pain and to spare sensation in sacral dermatomes. These lesions usually result in spastic paresis. 