Clinical Q&A for Stroke, Seizures, Myopathies
& Neuro Emergencies (160+ Questions and
Answers).
Progressively worsening focal back pain that is WORSENED in recumbent position
Spinal cord Compression (epidural) --> due to distension of epidural venous plexus when lying down
Progressively worsening focal back pain that is IMPROVED in recumbent position
Degenerative joint disease
Best way to diagnos for Spinal Cord Compression
Emergent MRI
Treatment of Epidural Spinal Cord Compression
Glucocorticoids
Work up for back pain + myelopathy symptoms
MRI
Work up for back pain without myelopathy symptoms
X-ray
Low back pain with tenderness at affected level and decreased spinal mobility.
Pain worsened with standing, walking, or lying on back
Acute Vertebral compression fracture
What condition is indicated with spinal apophyseal (facet) joint arthritis
Spondyloarthropathy
, Low back pain in paraspinal area without significant tenderness to palpation that worsens with
movement and improves with rest
Ligmentous back sprain
- Gradually worsening, severe, local back pain
- Back pain worse in recumbent position/at night
- LE weakness/LE paresis
- Loss of rectal tone
- Complete Sensory loss of LE
- Urinary retention
- Hyper-reflexia, (+) Babinksi, weakness w/o fasciculations
Spinal Cord Compression
- Severe radicular pain
- Saddle anesthesia
- Asymmetric motor weakness
- Hyporeflexia
- Late-onset bowel and bladder dysfxn
Cauda equina syndrome
- Sudden onset severe back pain
- Perianal anesthesia
- Symmetric motor weakness
- Hyperreflexia
- Early-onset bowel and bladder dysfxn
Conus medullaris syndrome
What part of nervous system is injured with Cauda Equina Syndrome
Sacral spinal roots
What is underlying cause with signs of Spinal cord compression and fever
Epidural abscess
Risk factors for Epidural Abscess
- Vertebral body osteo --> continguous tisse infxn
- Steroid injections/ Epidural anesthesia --> direct inoculation
- IV drug use
- Immunocompromised = DM, HIV, alcoholism
Most common bug with Epidural Abscess
Staph aureus
Best way to confirm diagnosis of Epidural abscess