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1) Poliomyelitis or Werdnig Hofman

-LMN lesion only


-Destruciton of Anterior Horns
-Flaccid Paralysis
-Symptoms: malaise, headache fever, nausea, soar throat
-CSF pleocytosis, slight elevation in protein, no elevation in CSF
-Viral culture from oropharynx

A) Poliovirus
-Fecal Oral Trnasmission
-short genome and simple composition
+ssRNA
-non-enveloped
-icosahedral protein capsid
-poliovirus is widely regarded as the simplest signifcant virus
-Replicates @ oropharynx + SI
-Spreads to bloodstream and CNS
Group: Group IV ((+)ssRNA)
Order: Picornavirales
Family: Picornaviridae
Genus: Enterovirus

B) Werdnig-Hofman
-AR, foppy baby, tongue fasciculaitons
-death at 7 monthes
2) Multipl Sclerosis
-mostly white matter of cervical region
-random asymetric lesions
-due to demylination
-Scanning speech
-Intension tremor
-nystagmus
3) Amyotrophic lateral sclerosis
(ALS/lou gerhigs)
-combined UMN + LMN defcits
-No sensory defcits
-both UMN + LMN signs
-defect in SOD1
-Rx: riluzole medestly lengthens survival by decreasing presynaptic Glu
5) Anterior spinal artery sydrome
-Complete occlusion of ASA
-Spares DCML
-upper thoracic ASA territory is a watershed area
-great artery of Adamkiewics supplies ASA below T8
(this allows localization of lesion)
(occlusion of the great artery is a milder (still bad) syndrome than complete ASA syndrome)
6) Tabes Dorsalis
-tertiary syphillis
-degredation of doral roots
-degredation of dorsal columns
-impaired sensation, proprioception
-locomotor ataxia
-Associated with Charcots Joints = lightning pain
-Argyll Robersons pubil
-Absense of DTRs, + Rhomberg
-Sensory ataxia at night
7) Syringomyelia
-Damages AWC of spinalthalamic tract (2nd order neurons)
-bilateral loss of pain and temp (AD/C fbers) 2-30m/s
-usually seen at C8/T1
-CMT1/2
-can expand and afect other tracts
8) Freidreichs Ataxia GAA TNR
-subacute combined degeneration/Axonal
of DC & LCST & Spinocerebellar tracts
-staggering ataxic gait
-hyperrefexia, frequent falling
-Nystagmus, dysarthia, pes cavus, hammer toe
-cause of death is hypertrophic cardiolyopathy
-presents at childhood with kypphoscoliosis
-impaired position and vibration sense
9) B12/E df
-subacute combined degeneration/
demylination of DC & LCST & Spinocerebellar tracts
-ataxic gait
-hyperrefexia
-impaired position and vibration sense
10) Brown-Sequard Syndreom
-Hemisection of spinal cord: fndings
1) Ipsilateral UMN signs (corticospinal)
2) Ipsilateral loss of tactile vibration below lesion (DCML)
3) Contralateral pain and temp loss (spinothalamic)
4) Ipsilateral loss of all sensation and facid paralisis @ level of lesion
5) if above t1 ipsilateral horners
11) Lumbar disc herniation
-most often between L4 & L5 or between the L5 & S1
-Symptoms: lower back, buttocks, thigh, anal/genital region (via the Perineal nerve)
-may radiate into the foot and/or toe.
-The sciatic nerve is the most commonly afected = sciatica.
-The femoral nerve can also be afected
= numb, tingling feeling throughout one or both legs
-burning feeling in the hips and legs.
"Great radicular artery of Adamkiewics
It typically arises from a left posterior intercostal artery
-which branches from the aorta
-supplies the lower two thirds of the spinal cord via the anterior spinal artery
-provides the major blood supply to the lumbar and sacral cord
CC:
-When damaged or obstructed, it can result in anterior spinal artery syndrome
-with loss of urinary and fecal continence
-impaired motor function of the legs
-sensory function is often preserved to a degree.
-It is important to identify the location of the artery when treating a T/AAA
Spinal Cord Lesions

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