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Medicine

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Neurology

Question
11 out of 12
 

Spastic paraplegia is caused by all, except: (AI 2009)



A Vitamin B12 deficiency
B Cervical spondylosis

C Lead poisoning
D Motor neuron disease

Ans. C

Lead poisoning (It leads to peripheral motor neuropathy) (Ref. Hari-18th ed., pg 3466)

Extra Edge: In lead poisoning it resembles radial neuropathy, ANP & blue line in gum (Burton lines)

Causes of spastic paraplegia

1). Cervical spinal cord

2). injuryDecompression sickness

3). Infectious Disorders (Specific Agent)


a. HIV

b. Syphilis

c. Potts paraplegia/Epidural cold abscess

d. Tabes dorsalis


4). Infected organ, Abscesses

Spinal epidural abscess

5). Neoplastic Disorders


a. Cervical / Thoracic spinal cord tumor

b. Metastasis to spinal cord

c. Intraspinal tumor

d. Spinal Meningioma

e. Multiple Sclerosis


6). Deficiency Disorders

a. Copper deficiency

b. Vitamin B12 deficiency (Subacute combine degeneration)

7). Congenital, Developmental Disorders

a. Congenital narrow neural canal/Cervical

b. Syringomyelia

8). Hereditary, Familial, Genetic Disorders


a. Hereditary spastic Paraplegia

b. Friedreich’s ataxia

c. Hereditary Spinocerebellarataxia type I

9. Anatomic, Foreign Body, Structural Disorders


a. a. Spondylosis, cervical

b. Cervical spinal stenosis

c. Parasagittal Brain Lesion


10). Drugs

Nitrous oxide (N2O) Administration/Toxicity/abuse

11). Poisoning (Specific Agent)

Lathyrism

Extra Edge:

Transverse Myelitis

Acute / subacute generally monophasic, inflammatory disorder of the spinal cord.

Causes.

1). Immunological – Post infections – Influenza, measles, varicella, rubella, mumps, EBV, CMV, Mycoplasma

2). Post vaccine – rabies, influenza

3). Demyelination – MS

4). Connective tissue disorders – SLE, Sjögren’s syndrome, Beh|et’s disease, sarcoidosis.

1). Diagnostic criteria –

a. Acute/Subacute onset

b. Truncal sensory level

c. Absence of other known neurological disease

d. Lack of progression over 4 weeks

e. Motor, Sensory & Sphincter disturbances

f. No clinical/ lab evidence of cord compression

2). Clinical features

a. Most common site upper/ mid thoracic cord

b. Initial symptom focal back pain/ neck pain.

c. Paresthesia, sensory, motor, sphincter disturbances within hours to days.

d. Areflexia initially Hyperreflexia.

CSF – Pleocytosis, Proteins mildly increase.

3). Poor prognosis –

a. Spinal shock

b. Severe back pain

4). Treatment – I.V. Methyl Prednisolone followed by oral prednisolone

Neurology Flashcard List

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