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Spinal cord lesions

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Demyelination in the spinal cord often accounts for the sensory and motor symptoms seen in multiple sclerosis:

  • commonly, plaques occur high in the dorsal columns and present with symmetrical tingling in both upper limbs, often in the hands, and up the inner aspects of the forearms. Patients describe their fingers as being swollen.
  • sensory symptoms may begin distally in the lower limbs and progress proximally to the trunk, mid-thorax or waist.
  • loss of proprioception and co-ordination
  • Lhermitte's sign - from active plaques in the cervical region
  • demyelination of the pyramidal tracts results in heaviness and dragging of one or both legs - exacerbated after walking
  • advanced demyelination may produce an acute paraplegia

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