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Medicine

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Neurology

Question
5 out of 12
 

Painless burn in hand is a characteristic feature of: (DNB Dec 2009)



A Syringomyelia
B Motor neuron disease

C Cord compression
D SLE

Ans. A

Syringomyelia

Brown Séquard syndrome

Brown Séquard syndrome (Hariemisection of the cord)

1). Sensations lost on the same side as the lesion (Ipsilateral posterior column involvement)

a. Vibration

b. Joint Position (Proprioception)

c. Fine touch

2). Motor power is lost on the same side as that of the lesion (Ipsilateral corticospinal tract involvement)

3). Sensation lost on the opposite side of lesion (Contralateral spinothalamic tract involvement).


a. Touch (Crude touch)

b. Pain

c. Temperature


Syringomyelia

1). Syringomyelia is a cavitatory expansion of central canal of spinal cord caused by chronic progressive destruction of its Grey & White matter.

2). The most commonly involved regions are the ‘Lower cervical’ and ‘upper thoracic’.

3). Since the disease usually starts at the base of the posterior horns of the lower cervical spinal cord, it tends to involve the sensory fibres, which cross the midline to form the spinothalamic tract.

4. As these fibres carry the sensations for temperature & pain, one of the earliest signs of disease is an inability to differentiate or appropriate ‘Hot and Cold’ sensations on the inner side of forearm and hand.

5). Thermo-anaesthesia usually precedes the Analgesia while Touch sensitivity is usually preserved (This leads to Multiple burns and non-healing ulcers over the hands and forearms)

6). This particular form of “sensory loss” to temperature & pain with sparing of touch, is described as ‘Dissociate Anaesthesia’ and is considered as the “True Hallmark of the disease”.

Neurology Flashcard List

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