Spinal cord infarction with ipsilateral segmental neuropathic pain and flaccid paralysis. A functional role for human afferent ventral root small sensory fibres
Autor: | Ricardo Hughes, R J Guiloff, Mario Campero, Patricia Orellana, Jorge A. Bevilacqua |
---|---|
Rok vydání: | 2018 |
Předmět: |
Spinothalamic tract
Sensory Receptor Cells Anterior spinal artery Somatosensory system 03 medical and health sciences Young Adult 0302 clinical medicine medicine.artery medicine Humans 030212 general & internal medicine Treatment Failure Denervation Afferent Pathways business.industry Spinal Cord Ischemia Cervical Cord Anatomy Hypoesthesia Posterior column Nociception medicine.anatomical_structure Neurology Infarction Neuropathic pain Neuralgia Female Neurology (clinical) medicine.symptom business Spinal Nerve Roots 030217 neurology & neurosurgery |
Zdroj: | Journal of the neurological sciences. 395 |
ISSN: | 1878-5883 |
Popis: | This paper illustrates the cases of two patients with an acute onset of right brachial neuropathic pain, flaccid paralysis and contralateral thermal and thermal pain hypoesthesia, without posterior column impairment nor pyramidal signs below the segmental lesion. MRI showed right sided spinal cord infarction, in the anterior spinal artery territory between C1 and C5 in one patient and between C3 and C7 in the other. Contact Heat Evoked Potentials and Quantitative Thermal Sensory testing are consistent with contralateral, but not ipsilateral, spinothalamic tract involvement. Electromyographic results established ipsilateral segmental denervation and somatosensory evoked responses were consistent with dorsal column sparing. Unilateral anterior cervical spinal cord infarction may present with acute ipsilateral segmental neuropathic pain, lower motor neurone-type weakness, contralateral thermoanalgesia and no pyramidal signs. The ipsilateral pain provides novel evidence that in some instances, ventral roots can play a role in nociception in humans. The infarcted territory may result from occlusion of a sulcal commissural artery or a number of more proximal vessels (including a single or duplicated anterior spinal artery, vertebral arteries or feeding radicular arteries). |
Databáze: | OpenAIRE |
Externí odkaz: |