neurologic disorders
Nerve Root Disorders
Symptoms and Signs of Nerve Root Disorders
Radiculopathies tend to cause characteristic radicular syndromes of pain and segmental neurologic deficits based on the cord level of the affected root (see table Symptoms of Common Radiculopathies by Cord Level ). Muscles innervated by the affected motor root become weak and atrophy; they also may be flaccid with fasciculations. Sensory root involvement causes sensory impairment in a dermatomal distribution. Corresponding segmental deep tendon reflexes may be diminished or absent. Electric shock–like pains may radiate along the affected nerve root’s distribution. Pain may be exacerbated by movements that transmit pressure to the nerve root through the subarachnoid space (eg, moving the spine, coughing, sneezing, doing the Valsalva maneuver). Lesions of the cauda equina, which affect multiple lumbar and sacral roots ( Cauda Equina Syndrome ), cause radicular symptoms in both legs and may impair sphincter and sexual function. Findings indicating Spinal Cord Compression include the following: A sensory level (an abrupt change in sensation below a horizontal line across the spine) Flaccid paraparesis or quadriparesis Reflex abnormalities below the site of compression Early-onset hyporeflexia followed later by hyperreflexia Sphincter dysfunction 