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Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
“Dissociated” sensory loss below the level of the lesion: Pain, temperature, light touch loss.Discriminating touch, vibration, proprioception preserved.
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Published in Calver Pang, Ibraz Hussain, John Mayberry, Pre-Clinical Medicine, 2017
Calver Pang, Ibraz Hussain, John Mayberry
Syringomyelia is where a fluid-filled cyst exists within the spinal cord, which can enlarge and expand into the grey and white matter compressing the tissue of corticospinal and spinothalamic tracts and anterior horn cells. This causes dissociated sensory loss (absent pain and temperature sensation with preserved light touch, vibration and joint-position sense). Option C results from injury to the dorsal column medial lemniscus pathway and option D results from injury to the spinocerebellar tracts.
Examination of the Nervous System
Published in John W. Scadding, Nicholas A. Losseff, Clinical Neurology, 2011
Tim Fowler, John Scadding, Nick Losseff
Lesions that cause dissociated sensory loss include damage to one half of the spinal cord (Brown–Séquard syndrome), damage to the anterior half of the cord, and expanding intramedullary lesions. Each of these disorders will produce a particular pattern of dissociated sensory loss in combination with distinctive motor signs below the lesion. In the Brown–Séquard syndrome, there is ipsilateral loss of vibration and position sense, and impairment of tactile discrimination, with contralateral loss of pain and temperature sensation (Figure 3.20). Voluntary motor activity is lost on the side of the lesion. With damage to the anterior half of the spinal cord, there is bilateral loss of pain and temperature sensation and of voluntary motor activity, but preservation of touch, vibration and position sense. An intramedullary lesion that interrupts the decussating fibres from the dorsal grey column to the lateral spinothalamic tract often causes preferential loss of pain and temperature appreciation in a segmental distribution corresponding to the site of cord involvement.
Radiographic assessment of surgical treatment of post-traumatic syringomyelia
Published in The Journal of Spinal Cord Medicine, 2021
Yuping D. Li, Chris Therasse, Kartik Kesavabhotla, Jason B. Lamano, Aruna Ganju
Of the 19 total articles reviewed, eight primarily focused on the diagnosis of PTS.4–11 PTS symptomatology is varied and may manifest itself as any change in neurologic function, progression of pain, or autonomic dysfunction. Pain has been reported in anywhere from 60% to 80% of patients and can be radicular or central in nature.5,12 The sensory disturbance associated with PTS may be a dissociated sensory loss: loss of spinothalamic function and preservation of posterior column function. Other sensory abnormalities may include alteration/loss of sensation or new onset of ascending sensory loss. Both upper and lower motor dysfunction may be seen; paresis or changes in spasticity have been reported in as many as 30%.5 Autonomic dysfunction may manifest itself as hyperhidrosis, change in bladder/bowel function, or a new Horner’s syndrome.8,12–15
The factors affecting the outcomes of conservative and surgical treatment of chiari i adult patients: a comparative retrospective study
Published in Neurological Research, 2022
Anas Abdallah, İrfan Çınar, Meliha Gündağ Papaker, Betül Güler Abdallah, Özden Erhan Sofuoğlu, Erhan Emel
In the conservative group, the mean tonsillar herniation on midsagittal and coronal images was 8.8 ± 2.6 (3–16) mm and 9.3 ± 2.1 (4–18) mm, respectively. The mean ASV was 16.5 ± 2.7 (range; 12–25) µl (Table 4). The first line was successful in treating 22 patients (24.4%). The second line was successful in treating 42 patients (46.7%). The third line was successful in treating 19 patients (21.1%). We applied the fourth line to 7 patients (7.8%). We operated on five of these seven patients after the unsatisfied response of conservative therapy. The five patients experienced a neurological progression (except for the patient who experienced recurrent aspiration, the other four patients all experienced at least two new symptoms from the second and third categories). In these five patients, the ASVs were ≤15 (10–15) µl. The mean value of mCCOS after six months of conservative treatment was 10.4 ± 1.5 (range; 5–12). The median of the Pregabalin usage period was 5.5 years (range; 3–121 months). The comparison of treatment outcomes between both groups regarding the pretreatment symptoms was given in Table 5. Although the comparison led to bias, the surgical treatment was significantly effective to treat the dissociated sensory loss (p = 0.032), ataxia (p = 0.032), and a syrinx (p = 0.013). In the surgical group, the recovered patients were significantly higher (p > 0.0001). The comparison between (conservative treatment benefited) and (conservative treatment failed) patients was shown in Table 6. In the conservative group, strong positive correlations were noticed between high ASVs (>16.7 µl) and clinical improvement and between the increase in ASVs and clinical improvement (p = 0.004, rs = 0.4) and (p < 0.001, rs = 0.61), respectively.
Epidemiology of ATTRV30M neuropathy in Cyprus and the modifier effect of complement C1q on the age of disease onset
Published in Amyloid, 2018
Savanna Andreou, Elena Panayiotou, Kyriaki Michailidou, Panayiota Pirpa, Andreas Hadjisavvas, Adonis El Salloukh, Daniel Barnes, Antonis Antoniou, Petros Agathangelou, Katia Papastavrou, Kyproula Christodoulou, George A. Tanteles, Theodoros Kyriakides
The initial presenting symptoms of the 46 living patients are summarized in Table 1. The most commonly reported initial symptoms were “sharp shooting” or “burning” pains (74%) and the most commonly observed sign was dissociated sensory loss (96%).