Brown-Sequard Syndrome

Discussion in 'Step I' started by MudPhud20XX, 01.13.14.

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  1. MudPhud20XX

    MudPhud20XX 2+ Year Member

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    Kaplan neuroanatomy figure (IV-4-17) legend says the below:

    Ipsilateral and below lesion:
    1) impaired proprioception, vibration, 2-point discrimination, joint and position sensation
    2) spastic weakness --> Shouldn't this be more like flaccid paralysis? Since hemisection of the spinal cord should give ipsilateral LMN signs, correct? So is Kaplan wrong about this?

    I looked at FA for Brown-Sequard syndrome and it says: Ipsilateral LMN signs such as flaccid paralysis at the level of the lesion, which I agree with.

    Can anyone confirm if Kaplan is wrong?

    Many thanks in advance.
     
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  3. MudPhud20XX

    MudPhud20XX 2+ Year Member

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    Alright, so I guess you get both ipsilateral spastic weakness and flaccid paralysis since you damage both UMN and LMN of the corticospinal tract.

    So you get ipsilateral spastic weakness (UMN lesion) in the entire body below the lesion, but you get ipsilateral flaccid paralysis (LMN lesion) just at the level of the spinal cord lesion, correct?
     
  4. Ionian

    Ionian 2+ Year Member

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    Why do you have a question above EVERYTHING? Dude, read a book. Jesus.
     
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  5. notbobtrustme

    notbobtrustme Crux Terminatus Banned Account on Hold 2+ Year Member

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    yo bro, this is what this forum is for and many of his posts lead to good discussions. I'm not going to knock a dude trying to get additional help at all. And it helps to have a quick review when answering his questions or see that you have the right idea when others answer his question.
     
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  6. Ionian

    Ionian 2+ Year Member

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    Lets just hope when hes a doctor he'll be smart enough to know where to actually go/what resources to utilize to be able to actually be a good clinician.
    Not, oh crap my patient is coding, let me go ask what to do on SDN.

    A few questions is fine, but your a grown up now, god forbid you didn't have SDN cause you'd fail step, because your too dumb to know where to go for the correct answers.

    I really just think hes watching videos and too lazy to search for an answer via articles or books. Which annoys the crap out of me.
     
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  7. Transposony

    Transposony Do or do not, There is no try 5+ Year Member

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    Everyone can read a book and/or use Google.
    However, this is a forum for discussion which helps many less smart people like me to clear their concept(s).
     
    Last edited: 01.13.14
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  8. Transposony

    Transposony Do or do not, There is no try 5+ Year Member

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    Use the "Ignore" feature here .
     
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  9. GangaMaster

    GangaMaster Banned Banned Account on Hold

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    Don't use the ignore feature, use the like feature.
     
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  10. sanj238

    sanj238 2+ Year Member

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    I don't disagree with this post too much.

    I think some of the questions are easily readable/searchable. I think questions that are difficult to search- very conceptual- and not necessariliy explained well by review books - Kaplan etc are legitimate.

    That said- the question he has is a legitimate one that I only figured out after several read-throughs
     
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  11. sanj238

    sanj238 2+ Year Member

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    The easily missed concept here is that UMN for these tracts extends from the brain all the way DOWN THE spinal cord. UMN ends only when it hits the anterior or posterior horns and synapses onto the alpha motor neuron. Thus a motor corticospinal tract extends from the brain decussates medulla and down the corticospinal tract until it synapses onto an alpha motor neuron.

    (no need to worry about sensory here- since we're takling about motor issues) LMNs only include the alpha motor neurons. So in a hemi section- obviously half the section is lost- so there will be destruction to the alpha motor neurons that end p there- so you will see a ipsilateral LMN at that level. If you cut it off there you will also inhibit all the fibers that are UMN that travel below it- hence UMN lesion below.

    So based on this- what makes up the gray matter tissue and the white matter tissue of the spinal cord?
     

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