Download MBBS Paraplegia PPT Lecture PPT

CAUSES
CEREBRAL
SPINAL
PERIPHERAL

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CEREBRAL CAUSES
GRADUAL ONSET
SUDDEN ONSET
Parasagital meningioma

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Thrombosis of unpaired
ACA
Hydrocephalus
Cerebral diplegia
Superior sagital sinus

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thrombosis

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SPINAL CAUSES
COMPRESSIVE

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NON -
COMPRESSIVE
EXTRAMEDULLARY INTRAMEDULLARY
EXTRADURAL
INTRADURAL

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COMPRESIVE
EXTRAMEDULLARY
INTRAMEDULLARY
EXTRADURAL:

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Infection : abcess,
Infection : TB spine, epidural
tuberculoma
abcess
Secondaries : breast, prostate,

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Syringomyelia
lungs, ovary
Primary tumors :
Trauma : disc prolapse
astrocytoma, glioma,

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INTRADURAL :
ependymoma
Primary tumor :
neurofibroma, meningioma
AV malformations

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Infections : TB, syphillis

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FEATURES
EXTRAMEDULL INTRAMEDULLA
ARY
RY

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1. Root pain
Early and common
Rare
2. Sensory deficit
No dissociation of pain Dissociation of sensation

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3. Sacral sensation
Lost ( early )
Sacral sparing
4. LMN involvement
Segmental

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Marked with widespread
atrophy
5. Reflexes
Brisk, early feature
Less brisk, late feature

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6. Autonomic
involvement
Late
Early
(bowel and

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bladder)
Usually not marked
Common
7. Trophic changes
May be sensitive to

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No bony tenderness
8. Vertebral
local pressure
tenderness
Early and prominent

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Late and less pronounced
9. UMN involvement Frequent
Rare
10. Changes in CSF
(protieins)

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NON COMPRESSIVE
Congenital

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Trauma
Vascular : Ant spinal artery occlusion, vasculitis,
SLE
Infection : syphillis, TB, varicella zooster, CMV
Demylination

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Primary : multiple sclerosis
Secondary : post vaccination, para infectious
Nutrional : Vit B12 , lathyrism, Cu
Immunological : RA, sjogren's syndrome, Beheset's
disease

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Devlopmental : tethered cord syndrome, etc

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LMN TYPE OF LEISION
Lesion involving anterior horn cell
Acute anterior polymyelitis, Progressive

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muscular atrophy, Trauma
Lesion of peripheral nerve
GBS, cauda equina syndrome
Lesion of NMJ
Myasthenia gravis, drugs like aminoglycosides or

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organophosphorus insectisides
Lesion in muscles
myopathy

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