Chapter-05 Spinal Cord

BOOK TITLE: Neurology

1. Kenkre Rajendra B
Publishing Year
Author Affiliations
1. Goa, India
Chapter keywords


Failure of neural tube closure, anencephaly, meningomyelocele, bony defects due to axial mesodermal development without a persistent open neural tube. These include encephalocele, meningoceles spina bifida diastematomyelia. Myelomenigocele: Meninges and spinal cord have herniated through large vertebral defect. Associated spinal anomalies are syringomyelia double central canal, hydrocephalus if Arnoldchiari malformation present. Meningocele: Defect is usually at lumbosacral level and this could be associated with diastematomyelia or tethered cord. Syringomyelia Lower cervical cord is the most common location although lumbar syrinx does occur. Chiari Malformation: Cerebellar tonsillar herniation often associated with late hydrocephalus and cerebellar ataxia 50% of patients have syringomyelia. Vertebral column: Bony disease which may be congenital or acquired occipitlization of the atlas, Platybasia. Tumors of spinal cord discussed are meningioma. Multiple sclerosis: Similar to Europe and America in Asia too incidence and prevalence of multiplesclerosis is rising Devices disease common presentation of MS in Asian patients. Spinal cord subarachnoid hemorrhage following rupture of arteriovenous malformation, Blood Dyscrasias, Drug sensitivity MRI is of diagnostic value. In hereditary spastic paraplegias 18 genetic loci have been identified of which 10 are autosomal dominant, 3X-linked and 5 autosomal recessive. Acquired spastic paraplegias include tropical spastic paraplegias and HTLV-1 Myelitis: Trepenomapallidum antibodies have been demonstrated in 60% of patients and IgG antibodies against HTLV-1 is demonstrated by specific IgG index or presence of oligoclonal bands. On isoelectric focusing. Radiation myelopathy a variant of this myelopathy has been recently described in long term survivors of radiation to the para-aortic lymph nodes in the treatment of malignancy of testis. Subacute combined degeneration of the spinal cord about quarter of patients who have CNS involvement do not have hematological abnormalities. Estimation of serum B12 and substitution therapy with B12: to avoid irreversible damage to corticospinal tract.

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