006.2 – Spinal Cord Injury

Here’s number 2. Let me know what you think


The very smart and astute Chris Nickson points out that central cord syndrome normally presents with motor weakness in the distally (in the hands) rather than proximally in the case in the video.

My bad…

He is of course right and has a nice little mnemonic for remembering it MUD: Motor/Upper/Distal

And remember that the symptoms and signs are relative not absolute:

distal> proximal

Based on the pure anatomy – with the corticospinal tracts arranged somatotopically with the highest spinal segments most medial – one would expect proximal weakness (C5,6 etc..) more than distal (C7-8, T1 etc…). But since when does the textbook play ball with reality! Maybe it’s just representative of the level of lesion in cervical cord (ie a lower lesion when the upper segments have already exited the cord) but it has me beat. Let me know if you have a better answer

Either way the more important thing is that central cord syndrome more usually presents with distal not proximal upper limb weakness.

Kudos to Chris for spotting it.

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