Neurology-Numbness

Front 1

What is the positive and negative symptoms of abnormal sensory symptom.

Back 1

Positive symptoms- pins and needles

Negative symptoms-numbness.

Front 2

Name the 3 receptors responsible for cutaneous afferent innervation.

Back 2

nocireceptor
thermoreceptor
mechanoreceptor

Front 3

Name the 2 main sensory pathways

Back 3

1) spinothalamic tract (pain,temperature)-small fibers

2) posterior column-lemniscal system
(touch,pressure,proprioception)-large fibers

Front 4

Describe areas that can be localized in a patient presenting with numbness/pins and needles.

Back 4

Symptom may arise from
1) nerve and root
2) spinal cord
3) brainstem
4) thalamus
5) cortex

Front 5

Features suggesting a nerve and root problem

Back 5

1) sensory abnormalities are readily mapped and generally have discrete boundaries (according to dermatomes)

2) In polyneuropathies where sensory deficits are generally graded, distal, and symmetric in distribution ie: stocking-glove type.

3) Depends on involvement of small fibers or large fibers polyneuropathies.

Front 6

Features of large fiber polyneuropathy.

Back 6

Large-fiber polyneuropathies are characterized by:
1) vibration and position sense deficits,
2) imbalance,
3) absent tendon reflexes,
4) variable motor dysfunction but

Preservation of most cutaneous sensation.

Front 7

Features of short fiber polyneuropathy

Back 7

Small-fiber polyneuropathies are characterized by:
1) burning,
2) painful dysesthesias with reduced pinprick and thermal sensation but

Preservation of proprioception, motor function, and deep tendon reflexes.

Front 8

Examples of spinal cord lesion

Back 8

Brown-Séquard syndrome-absent pain and temperature sensation contralaterally and loss of proprioceptive sensation and power ipsilaterally below the lesion

Syringomyelia-dissociated sensory loss with impairment of pinprick and temperature appreciation but relative preservation of light touch, position sense, and vibration appreciation.

3) multiple sclerosis, cervical spondylosis, or recent irradiation to the cervical region- Dysfunction of the posterior columns in the spinal cord.

Front 9

Examplae of brainstem lesion

Back 9

Lateral medullary syndrome- contralateral sensory loss below face and ipsilateral loss on face.

Specifically, there is a loss of pain and temperature sensation on the contralateral (opposite) side of the body and ipsilateral (same) side of the face.

Cause-usually secondary to occlusion of PICA

Front 10

Features of a cortical lesion

Back 10

Most prominent symptoms are contralateral hemineglect, hemi-inattention, and a tendency not to use the affected hand and arm.

Two-point discrimination abnormalities are often found but primary sensation is usually intact

Front 11

Features of a thalamic lesion

Back 11

Hemisensory disturbance with tingling numbness from head to foot is often thalamic in origin.