Posterior column involved dorsal root ganglia 185

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Posterior column involved. Dorsal root ganglia. 185
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Tabes dorsalis:- Usually develops 15 - 20 years after syphilis infection. Major symptoms are lightning pain, ataxia, urinary incontinence. Lightning pain:- Lightning or lancinating pain are sharp stabbing pain and brief like a flash of lightning. More common in legs. • Are associated invariably with impairment of tactile pain and thermal sensation. 186
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Urinary incontinence:- Bladder is insensitive and hypotonic resulting in unpredictable overflow incontinence. Sometimes constipation, megacolon as well as impotence can occur . Ataxia:- Purely sensory ataxia. Charcoat joints and trophic ulcers can occur. 187
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188
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PERIPHERAL NEUROPATHY 189
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All are true about peripheral- neuropathy except - a) Glove and stocking anaesthesia (AI 99) b) Poximal muscle weakness c) Nerve-conduction deficit d) Decreased reflexes 190
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191
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Typically, three horns can be discerned:- 1) Anterior horn: Contains nerve cell bodies which gives rise to somatic motor nerves (‘lower motor neurons') supplying the skeletal muscles. They form the motor fibres of the peripheral nerve. 192
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2) Posterior horn: - It receives the sensory nerve via the dorsal root ganglia. Sensory nerves bring information from various areas of the body. The nerve cell bodies of these sensory neurons are situated little outside the spinal cord and constitute the dorsal (posterior) root ganglion. 193
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3) Lateral horns: - Conspicuous in the thoracic and upper lumbar segments of the spinal cord only. From these lateral horns the sympathetic fibres arise. Preganglionic sympathetic fibres arise from the lateral horn cells and accompany the ventral motor root. 194
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Formation of a mixed spinal nerve:- The two roots the motor and the sensory unite together little outside the spinal cord to form a mixed spinal nerve, (peripheral nerve) Therefore a spinal nerve contains both motor and sensory fibres i.e. it is a mixed nerve. Preganglionic sympathetic fibres arise from the lateral horn cells and accompany the ventral motor root. Subsequently these preganglionic sympathetic fibres leave the motor root to end in a sympathetic ganglion. 195
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So a lesion in peripheral nerve can affect all the fibres, i.e. motor, sensory and autonomic. Peripheral neuropathy is characterized by host of signs and symptoms that reflect involvement of sensory, motor and autonomic fibres. 196
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Sensory symptoms:- These symptoms begins in the most distal extent of the longest sensory fibres i.e. those that subserve sensation in the toes and the feet. Typically, all sensory modalities are affected to some extent including light touch, pain, thermal sensations, vibratory sense and joint position sense.
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  • Winter '16
  • jean grey

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