Spinal cord lesions
Lesions in the spinal cord produce a combination of segmental and long tract (longitudinal) signs.
Segmental signs are related to:
Lesions of the anterior root or anterior horn cell giving rise to a myotomal distribution of flaccid weakness, atrophy and fasciculations;
Lesions of the dorsal root or dorsal root entry zone giving rise to a dermatomal distribution of sensory loss;
Loss of reflex function, caused by disruption of the mono-synaptic stretch reflex arc;
Dermatomal pain from dorsal root irritation.
Longitudinal signs comprise:
Upper motor neuron lesions characterised by spastic weakness, hyper-reflexia, clonus, extensor plantar responses and loss of superficial cutaneous reflexes (abdominal and cremasteric);
Sensory loss below a sensory level.
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