II. Exam: Distinguishing Upper from Lower Motor Neuron Injury

  1. Upper Motor Neuron Lesion (lesion proximal to the spinal cord anterior horn cells)
    1. Hyperreflexia
    2. Clonus
    3. Motor Spasticity
    4. Increased muscle tone
    5. Babinski sign positive
    6. Muscles without atrophy (normal muscle mass)
  2. Lower Motor Neuron Lesion (lesion distal to the spinal cord anterior horn cells)
    1. Motor Weakness
    2. Muscle Atrophy
    3. Muscle Fasciculations
    4. Deep Tendon Reflexes decreased

III. Causes

  1. Complete transection of the spinal cord
    1. Complete Cord Syndrome
  2. Partial spinal cord injuries
    1. Anterior Cord Syndrome
    2. Central Cord Syndrome
    3. Spinal Cord Hemisection (Brown-Sequard Syndrome, rare)
    4. Neuropraxia (Stinger, Burner)
  3. Images
    1. CordSyndrome.jpg

IV. References

  1. Decker in Chorley and Bachur (2014) Overview of Cervical Spinal Cord Injuries..., UpToDate, Wolters-Kluwer
  2. Wagner (1997) Emerg Med Clin North Am 15:699-711 [PubMed]

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Ontology: Spinal cord syndrome (C0560648)

Concepts Injury or Poisoning (T037)
SnomedCT 282784007
English spinal cord syndrome, cord spinal syndrome, cord spinal syndromes, Spinal cord syndrome, spinal cord syndrome (diagnosis), Spinal cord syndrome (disorder)
Spanish síndrome de médula espinal (trastorno), síndrome de médula espinal