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Line 49: |
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| =Spinal Cord= | | =Spinal Cord= |
| + | ==Spinal Cord Compression== |
| + | *H&P: |
| + | *Dx: Sensory level, pain, weakness, numbness, or hyperreflexia below the level of compression, bowel/bladder incontinence and saddle anesthesia with caudal equina. Differential includes tumor, disc herniation, osteomyelitis, epidural abscess, aneurysm, epidural/subdural hematoma, fracture |
| + | *Tx: Based on etiology. Don't give steroids for infection. May need neurosurgical decompression. |
| + | ==Spinal Stenosis== |
| + | *H&P: Neurogenic claudication-low back pain that radiates to the buttock that is worse with spinal extension, walking downhill, and standing, better with walking downhill and leaning forward. Negative SLR. |
| + | *Dx: Degenerative changes and neuroforaminal narrowing on xray or MRI. |
| + | *Tx: NSAIDs, PT, multimodal, MNB, MND, ESI, laminectomy |
| + | ==Transverse Myelitis== |
| + | *H&P: Inflammatory spinal cord process without compression but with weakness, numbness, and autonomic dysfunction below the level of the lesion. |
| + | *Dx: Bright area on MRI. Test CSF to rule out HSV, VZV, Lyme, MS. |
| + | *Tx: Glucocorticoids. Plasma exchange. |
| + | ==Cord Syndromes== |
| + | Spinothalamic, corticospinal, rubrospinal, dorsal columns, anterior horns, dorsal horns |
| + | {| class="wikitable" |
| + | |+ Spinal Cord Syndromes |
| + | |- |
| + | ! Syndrome !! Spinal Tracts Involved !! Presentation |
| + | |- |
| + | | Syrinx || PAG? Anterior white commissure || Loss of pain and temperature bilaterally at the level of the lesion |
| + | |- |
| + | | Brown-Sequard || Hemi-cord dissection || Contralateral paralysis and hyperreflexia, Ipsilateral loss of pain and temperature below the lesion |
| + | |- |
| + | | Anterior || Corticospinal, Anterior horns || Ipsilateral LMN syndrome at the level of the lesion |
| + | |- |
| + | | Posterior || Dorsal columns, Spinothalamic, Dorsal horns || Loss of pain and temperature bilaterally below the level of the lesion |
| + | |} |