SDK
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In spinal cord hemisection...what effects occur at the level of lesion?????
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| cyra
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Ipsialteral band of cutaneous anesthesia at the level of the lesion due to destruction of the posterior root and its entrance into the spinal cord at the level of the lesion.
I am not sure whether this applies to the question....there would also be an ipsilat lower motor neuron paralysis and muscle atrophy due to damage to the ant gray column neurons and possibly by damage to the nerve roots of the same segment.Now this would correpond to the segment of lesion and would not necessarily be AT the level of the lesion....right?...i hope am making some sense here...correct me if i am wrong plz...
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| sethigulshan
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In Spinal cord hemisection, only the lower motor neuron paralysis occurs at the level of the lesion.
If we have all the motor problems on one side( it means LMNs and UMNs and dorsal columns are Involved on the ipsilateral side) and sensory problems( one level down that level) on the other side, thought process should go right to spinal cord lesion. How do you say what level of spinal cord is involved, we have LMN paralysis at the level of the lesion and UMN paralysis from there down.
If we are above level of T1 may be you should expect to see Horner's on the same side of the lesion.( interruption of hypothalamospinal tract)
Any thing more to add?
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| GMOB
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At the level of the hemisection we will have ipsilateral loss of all sensation, including pain and temperature. Also flaccid paralysis of those muscles innervated by the affected segments. Just to review, Horner syndrome is: Miosis, ptosis and anhydrosis, caused by lesion of sympathetic descending hypothalamic fibers. Syndrome is ipsilateral to lesion. Also, it happens if lesion is above T2.
Edited by GMOB on 07/27/05 - 05:29 AM
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| sethigulshan
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No you are wrong here GMOB, its not the ipsilateral loss of pain and temperature, its the contralateral loss of pain and temperature one segment below the lesion. Its the ipsilateral LMN deficit at the level of the lesion, UMN deficit from there on, also loss of touch, vibration and position on the same side.
You are right about the Horners, occurs only in lesions above the level of T1, also ipsilateral.
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| GMOB
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I got this info from Kaplan's Anatomy book. page 344 and 345 from 2002 books. You might want to review it to get your concepts right. Also, read the question: what effects occurs at the level of lesion????? quoting kaplan " Horner occurs if lesion is above T2" NOT T1. Again, page 345.
Hope this helps!
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| SDK
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1)Ipsilateral LMN lesion.
2)Bilateral loss of pain & temprature.
3)Ipsilateral loss of position,vibration & two point descriminative touch.
4)Ipsilateral horner syndrome if lesion is above T2..
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| SDK
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As u know that spinothalamic tract fibres cross the midline in spinal cord below white matter commisure so at the level of lesion both crossed(from normal side) & uncrossed fibres are involved....so there shud be bilateral loss of pain & temperature.
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| ssrpk
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in spinal cord hemisection, there will be 2 long tract ipsilateral lesions [touch and pressure & UMN lesion] and one long tract contralateral lesion [pain and temperature]
however realize tht at the level of the lesion, alpha motor neurons will be severed tht will result in ipsilateral LMN lesion and by the same token, the incoming central fibers of the dorsal root ganglia will also be affected which will result in ipsilateral complete anethesia [all sensory modalities; touch, pressure, pain and temperature]
i don't think at the level of lesion there will be bilateral loss of pain and temp. at the same level because the incoming severed dorsal root fibers were destined to cross the midline one or two segments abv the lesion while the crossing fibers in the ventral comminssure at the level of the lesion hv entered spinal cord 1 or 2 segments below the lesion so they will be included in the context of contralateral loss of pain and temperature.
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| ssrpk
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however in case of syringomyelia where the syrinx encroaches on the ventral comminssure there will be bilateral loss of pain and temperature at the same level but, again 1 or 2 segmenst below the level of the lesion!
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| SDK
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see the figure on page no:345 kaplan anatomy.....
I read that spinothalamic tract fibres cross at the same segment where they synapse with dorsal horn...before synapsing with dorsal horn they ascend /descend in multiple segments....
contralateral loss of pain & temperature occur below the level of lesion not at the level of lesion.....
Just think...
a)incoming fibres on same side thru dorsal root are affected.
b)Fibres from opposite side which are crossing thru midline at the level are also affected.
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| sethigulshan
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I agree with ssrpk.
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| sethigulshan
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Ok to repeat.
Ipsilateral band of cutaneous anesthesia at the level.
LMN deficit at the level, ipsilateral.
UMN deficit down the level, ipsilateral
Dorsal Column deficit down the level, ipsilateral
Contralateral loss of pain and temperature from 1 or 2 segments down.
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| GMOB
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Thanks for confirming the info ssrpk! 
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