Dorn Spinal Therapy
Clinical Features |
Site of Lesion |
Possible Causes1 |
Localized sensory disturbance (not in a dermatomal or peripheral nerve distribution)2 |
Cutaneous nerves/ receptors |
Skin lesions, scars, lepromatous leprosy (dissociated sensory deficit3 distally in the limbs, tip of nose, external ear) |
Often pain and paresthesia at first, then sensory deficit, in a distribution depending on the site of the lesion |
Distal peripheral nerve |
Mononeuropathy (compression, tumor), mononeuritis multiplex (involvement of multiple peripheral nerves by vasculitis, diabetes mellitus, etc.) |
Distal symmetrical sensory disturbances |
Distal peripheral nerves |
Polyneuropathy (diabetes mellitus, alcohol, drug/toxic, Guillain-Barre syndrome) |
Bilateral symmetrical or asymmetrical thigh pain |
Peripheral nerves, lumbar plexus |
Diabetes mellitus |
Multiple sensory and motor deficits in a single limb |
Plexus |
Trauma, compression, infection, ischemia, tumor, metabolic disturbance |
Unilateral or bilateral, monoradicular or polyradicular deficits |
Nerve root |
Herniated disk, herpes zoster, Guillain-Barre syndrome, tumor, carcinomatous meningitis, paraneoplastic syndrome |
Spinal ataxia, incomplete or complete cord transection syndrome (p. 48) |
Vascular, tumor, inflammatory/multiple sclerosis, hereditary, metabolic disease, trauma, malformation | |
Loss of position and vibration sense in the upper limbs and trunk, Lhermitte's sign |
Craniocervical junction |
Tumor, basilar impression |
Contralateral dissociated or crossed sensory deficit (p. 70 ff) |
Vascular, tumor, multiple sclerosis | |
Contralateral paresthesia and sensory deficits, pain, loss of vibration sense |
Vascular (p. 170), tumor, multiple sclerosis | |
Paresthesia, contralateral sensory deficits (astereognosis, loss of position sense and two-point discrimination, inability to localize a stimulus, agraphesthesia) |
Postcentral cortex |
Vascular, tumor, trauma |
1 The listing of possible causes is necessarily incomplete. 2 May be factitious or psychogenic. 3 Impairment or loss of pain and temperature sensation with preserved touch sensation.
Ganglionic lesion — (loss of deep sensation leads to marked ataxia)
Radicular lesion — (dorsal root)
Localization of spinal and radicular sensory disturbances
Ganglionic lesion — (loss of deep sensation leads to marked ataxia)
Radicular lesion — (dorsal root)
Posterior column lesion (loss of position sense, pallesthesia, graphesthesia, stereoanesthesia, and Lhermitte's sign in cervical lesions)
Localization of spinal and radicular sensory disturbances
Posterior horn lesion (loss of pain and temperature perception, reflex impairment with preserved posterior column sensation)
Sensory dissociation, muscular atrophy, scoliosis due to syringomyelia
Radicular sensory disturbances and pain in herpes zoster
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