Clinical signs are caused by damage to the grey matter and white matter of the spinal cord. Pain, temperature, vibration, proprioception and dermatomal sensations all may be diminished, which will depend on the exact area of the cord or nerve-root which is compromised. Patients may also complain urinary urgency, hesitation and frequency but infrequnetly of urinary incontinence and retention. Fecal incontinence is very rearly present. Decreased tendon reflexes (hyporeflexia), muscle weakness and sensory disturbance in the upper extremities are signs of grey matter lesions. Hyperreflexia (decreased ankle and knee reflex), negative cremasteric reflex, positive Babinski’s sign and sensory disturbance in the lower extremities/trunk are the signs of white matter lession.
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Sensory disturbance such as numbness and tingling sensation in the hands is extremely common which starts start in the fingertips, are confined to the hand, and occur in a nonradicular distribution and is often misdiagnosed as peripheral neuropathy sometime carpal tunnel syndrome as well. Clumsiness of the hands leads an weakness in carrying out fine motor movements. There may be marked wasting of the intrinsic hand muscles of hands. Ono et al. described two specific signs of the myelopathy hand: (a) Fnger escape sign (i.e.: when patient is asked to fully extend the fingers with the palm facing down, the ulnar digits tend to drift into abduction and flexion within 30-60 seconds) and (b) Grip and release test (i.e.: because of weakness and spasticity of the hand result in a decreased ability to rapidly open and close the fist. Normally people can make a fist and release it 30 times in 15 seconds but in these patients these are
Sensory disturbance such as numbness and tingling sensation in the hands is extremely common which starts start in the fingertips, are confined to the hand, and occur in a nonradicular distribution and is often misdiagnosed as peripheral neuropathy sometime carpal tunnel syndrome as well. Clumsiness of the hands leads an weakness in carrying out fine motor movements. There may be marked wasting of the intrinsic hand muscles of hands. Ono et al. described two specific signs of the myelopathy hand: (a) Fnger escape sign (i.e.: when patient is asked to fully extend the fingers with the palm facing down, the ulnar digits tend to drift into abduction and flexion within 30-60 seconds) and (b) Grip and release test (i.e.: because of weakness and spasticity of the hand result in a decreased ability to rapidly open and close the fist. Normally people can make a fist and release it 30 times in 15 seconds but in these patients these are