neurologic disorders
Overview of Spinal Cord Disorders
Symptoms and Signs of Spinal Cord Disorders
Neurologic dysfunction due to spinal cord disorders occurs at the involved spinal cord segment (see table Motor and Reflex Effects of Spinal Cord Dysfunction by Segmental Level ) and at all segments below it. The exception is the central cord syndrome (see table Spinal cord disorders cause various patterns of deficits depending on which nerve tracts within the cord or which spinal roots outside the cord are damaged. Disorders affecting spinal nerves, but not directly affecting the cord, cause sensory or motor abnormalities or both only in the areas supplied by the affected spinal nerves. Spinal cord dysfunctioncauses Paresis Loss of sensation Reflex changes Autonomic dysfunction (eg, bowel, bladder, and erectile dysfunction; loss of sweating) Dysfunction may be partial (incomplete). Autonomic and reflex abnormalities are usually the most objective signs of cord dysfunction; sensory abnormalities are the least objective. cause upper motor neuron dysfunction. Acute, severe lesions (eg, infarction, traumatic lesions) cause spinal shock with flaccid paresis (decreased muscle tone, hyporeflexia, and no extensor plantar responses). After days or weeks, upper motor neuron dysfunction evolves into spastic paresis (increased muscle tone, hyperreflexia, and clonus). Extensor plantar responses and autonomic dysfunction are present. Flaccid paresis that lasts more than a few weeks suggests lower motor neuron dysfunction (eg, due to Guillain-Barré Syndrome (GBS) ). include the following (see table Spinal Cord Syndromes ): Transverse myelopathy Brown-Séquard syndrome Central cord syndrome Anterior cord syndrome Conus medullaris syndrome Cauda Equina Syndrome None 