Sensory Disorders

Spinal Cord Lesion

MYELOPATHY - deficit related to the cord

Hemicord

Central Cord

Anterior/Posterior Cord

Parietal Lobe/Sensory Cortex

Brainstem

Thalamus

Relay center of the brain. Everything goes through the thalamus.

Nerve Root/Plexopathies

Brachial Plexopathy

Lumbosacral Plexopathy

Tabes Dorsalis

Lyme Disease

Peripheral Nerve Lesions/ Peripheral Neuropathies

Polyneuropathies

Axonal Neuropathy

Myelinopathy - demyelinating

Guillain Barre Syndrome

https://www.youtube.com/watch?v=c-8ia81XPMw

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Diphtheria

some paraneoplastic disease

Metabolic/ Nutritional Neuropathies

Infective and Granulomatous Neuropathies

Mononeuropathies

Entrapment Neuropathies

CLINICAL FINDINGS

Sensory Disturbances

Sensory fiber involvement can lead to numbness and impaired sensation; abnormal spontaneous sensations such as paresthesia.

Pain

The precise mechanism of its genesis is unclear.

Dissociated Sensory Loss

Dissociated sensory loss involves impairment of some sensory modalities such as pain and temperature with preservation of others such as light touch, vibration and joint space position (proprioception). Can occur in spinal cord injuries but also in peripheral neuropathies.

Motor Deficits

Tendon Reflex

Impaired or lost if reflex arcs are interrupted.

Autonomic disturbances

Enlarged nerves

INVESTIGATIVE STUDIES

EMG

NCV

NERVE PAIN RELIEF

Duloxetine/ Venlafaxine (SNRI)

Pregabalin

amitriptyline

gabapentin/lamotrigine/topiramate

Phenytoin/carbamazepine/mexiletine

topical capsaicin

AUTONOMIC DISTURBANCES

Postural hypotension - esp in diabetic polyneuropathy