Spinal syndromes

Knowledge of spinal cord syndromes is important to be able to locate the lesions that may occur in the central nervous system and any disorder that may occur in the spinal cord.. Any motor type injury can be detected as sensitive type.

Here we are going to introduce you to the types of syndromes and their clinical manifestations.

Spinal Cord Syndrome Complete the Bastia Syndrome

In this situation there is an accident that has occurred at the level of the spinal cord., well be traumatic, hemorrhagic or infectious. Causing that medullary segment is injured and consequently the surrounding fibers are mutated. Below this segment he will be incommunicado to receive motor orders, like sensitivity will be lost.

The patient will present a partial paralysis, localized in the lumbar region of parapalesia type with lesion in the first motor neuron, because the pyramidal route has been cut.

As a consequence there will be exaltation of the reflexes and the Babinski sign.

Symptoms of Whole Spinal Section Syndrome

• Spinal shock in the first weeks where reflexes are canceled.
• Sphincter disorders that can cause urinary retention, incontinence and in some cases constipation.
• Sexual dysfunction.
• Various vegetative alterations.
• Alteration of bilateral total anesthesia below the level of the lesion.

Brown Sequard syndrome

It is also known as Medullary Hemisection Syndrome. It is an alteration of a hemimédula only, therefore it is classified as an incomplete spinal cord injury.

These lesions can occur as a result of an infection, from trauma due to sharps, absence of blood in the area, degenerative tumors or diseases.

So if this hemimédula is cut, below the injury there will be ipsilateral alterations. The patient will have ipsilateral first motor neuron palsy and anesthesia for posterior cord sensation (for pain and temperature). There will be an override of vibratory sensitivity.

Symptoms of Brown Sequard Syndrome

• Termoanalgesia contralateral.
• Hipsilateral paralysis.
• Loss or decrease of sensitivity and sensory perception.
• Proprioceptive system dysfunction.
• Termoanalgesia contralateral.
• Weakness and Paralysis.

Spinal Compression Syndrome

It is a syndrome that manifests itself due to a tumor or a metastasis to the spinal cord. By pressing laterally the medulla will cause an alteration of the pyramidal pathway and spinothalamic sensitivity. In some cases it has affected posterior cords, but it is rare.

The patient will present with a first motor neuron paralysis. If the injury occurs at the level of the cervical plexus or lumbar plexus, we will have an ipsilateral and segmental second motor neuron paralysis.

It can end with a loss of neurological function irreversibly if not treated in time.

If the development is acute it evolves in less than 48 hours, if it is subacute it can evolve in days or weeks.

Symptoms of Spinal Compression Syndrome

• Back pain.
• Pain worsens when movements such as flexing the neck occur, Valsalva maneuver, cough or flex the lower extremities.

Treatment for Spinal Compression Syndrome

This syndrome has traditionally been treated with radiation therapy, although at present new techniques of radiation and surgery are being applied with favorable results.

Anterior Spinal Artery Syndrome

Presents as spinal infarcts, either unilateral or bilateral. In this case, half of the spinal cord is usually affected.. The structures most affected below the injury are the pyramidal pathway, the spinothalamic pathway and the second motor neuron.

The patient will present a bilateral second motor neuron paralysis that can affect both arms and legs and a loss of sensitivity to pain and heat.

Symptoms of Anterior Spinal Artery Syndrome

• Tingling or numbness.
• Sphincter alterations.
• Partial paralysis of the legs and in some cases includes the arms.
• Sensitive alterations.

Schneider syndrome

Schneider syndrome, also well known as centromedullary contusion syndrome, is a set of symptoms and conditions that can arise as a result of trauma or iatrogenic damage. In other words, is a clinical picture resulting from a spinal injury, then when the central part of the spinal cord suffers a contusion these symptoms occur. Motor dysfunction will appear.

The diagnosis of Schneider syndrome is clinical, trauma can hardly be seen on an MRI.

Symptoms of Schneider syndrome

Symptoms will vary depending on the severity of the injury or trauma.. In some cases they may appear:

• Loss of thermal sensitivity.
• Partial paralysis or weakening of the contractility of the muscles of the upper limbs without affecting the functioning of the lower limbs.
• General weakness in 4 extremities of the upper limbs (tetraparesia).
• Loss of painful sensation.

Schneider syndrome treatment

Treatment will also depend on the causative agent. It is advised to use medications that help reduce the symptoms of edema. A cervical collar will be recommended, if the injury was by effect lash. Physical therapy can contribute to a speedy recovery.

For severe cases, corticosteroid treatment can be done, which are a group of steroid-type hormones. In any case, cervical rest is recommended..