I was wondering about the statement that cord compression released by flexion and nerve root relieve by extension. Straight leg raise tenses the dura and arachnoid and that is a kink of flexion. Conversely stenosis which affects roots is relieved by flexion. Any comments??
As a 3rd year neurology resident, I can say this is probably the best and most organized lecture about spinal cord disorders!! AMAZING.. Thank you very much for the great effort.
These are beyond awesome, such high yield learning points, great illustrations and animations and the little videoclips of juxta-relevant entertainment is a combination I have yet to find elsewhere. You do a service to neurology all around the globe, and I would gladly even pay for this quality. P.S. Don't make us pay for this.
Great series, RU-vid is a nice platform that we can see different excellent tutorials from different teachers from their different perspectives. They piece together to make me understand better. I follow up with your great series. Learning efficiency is much higher. Look forward to your more excellent tutorials.
Splendid job. I suggest you to place medical disclaimers on every video as books or the "strong medicine" cannel does in order to avoid conflicts later on. Thank you for your dedication.
as a patient, this is the best resource i've encountered yet that explains why my doctors ran the tests the did when i presented with demyelinating symptoms. thank you for making this.
I can't describe my happiness with this awesome lecture; it made my day indeed.... Thanks alot, alot,... I really appreciate your great effort in making this...and really, I am waiting for more and more lectures🙏🙏.....Thanks alot☘☘
Paraplegia is more of a localization issue - bilateral medial frontal lobes vs spinal cord (at any level) vs peripheral nerve roots vs peripheral nerves. So neuropathy vs plexopathy vs radiculopathy vs myelopathy vs frontal pathologies. If you can identify the correct localization, pathology and management will follow. I'll make a localization video soon to explain.
Awesome, I am learning so much, I am enjoying all your lecture series. You are some, Spinal cord always scared me but I think I am getting hold of the concept
Still awaiting an 'official' diagnosis after a year of scans and 'terms' expressed in the occasional letters from hospitals and Consultants. Arteriovenus Fistula being the latest and oft used within them. When information is in short supply (to patients) you have to go looking for potential explanations (sadly). Of all the 'research material' i've been looking through, this video was more enlightening (maybe) Thank you.
Am dr behaylu pediatric neurology fellow you present very attractive, entertaining and informative presentation thank you. 2 questions 1. in acte case of compressive transverse myelitis giving 10 mg dexamethasone, couldn't it may worsen if the disease is epidural abscess 2 . how can I get the slide
Thank you for this amazing lecture! Is bladder dysfunction due to involvement of the sacral corticospinal fibres or motor autonomic fibres in the lateral horn. You seem to mention both.
Thank you so much Sir, you are awesome. The way that you have explained this complex topic in such a simplified manner shows your expertise and brilliance. I am really grateful to have attended your lecture. Thank you So Much.
I’m a bit confused about motor pathways damage and pattern of weakness If say both - anterior horns and corticospinal tracts would be damaged then what pattern of weakness (LMN or UMN) would the patient exhibit? Excuse my imperfect English Thanks in advance
That’s an excellent question. Anterior horns at each spinal level supply the muscles at that dermatome. But motor tracks are continuous. If you acutely damage motor tracks in the cervical cord for example, patients may have quadriplegia. Cervical cord lesions may also damage the cervical anterior horns, but since the arms will already be weak from motor track damage, the signs of anterior horn damage will be masked. So in general, with acute cord injury, motor track damage takes priority clinically. In chronic lesions (like motor neuron disease), you may be able to see lower motor neuron signs associated with anterior horn lesions (fasciculations, wasting, decreased reflexes) and/or upper motor neuron signs with motor tract damage (spasticity, Babinski, hyper-reflexia).
Thank you very much for such a great explanation but i have one question In minute 4:10 you mentioned flexion decreases size of intervertebral foramina i looked it up it actually increases it or am i missing the point if so please do explain it if possible
Flexion should decrease the size of intravertebral foramina while increasing the size of spinal canal. Hence flexion worsens pain from radiculopathy but makes the pain from spinal stenosis a little better.
I have Cervical-Spinal-Stenosis so after years of being told by family and friends I was a " Pain in the Neck" they were all correct! Just had # 2 of 3 epidural neck shots- We Shall See after #3 if it were worth traveling 50 miles to- 50 miles from because my Community hospital close by doesn't offer this as well as many Other Things! Why do I ever go There? THEY ARE Close? PRETTY POOR EXCUSE! Yeah- should just move back to city where my State LandGrant university and their Very Very good medical college and Hospital are located!
Intervertebral foramina reduces with flexion. One maneuver to bring on the pain of cervical radiculopathy is to tilt the head to the side and press down on the top (Spurling test).
Hi doctor, in 16:33 you said the sensory deficit deficit is in ascending pattern, however most lateral part of posterior column is the innervation of cevical area ; does the proprioception loss happen in descending pattern?
Proprioception deficit with cord compression is really impossible to detect at the bedside, so we focus on pinprick/light touch instead. That is more reliable.
@@theneurophile Can I ask whether the patient description of pain effectively differentiate pain between dorsal column compression , anterolateral system compression , or dorsal root compression?
@@user-wr9ks3tf4n Description of pain is unfortunately very non-specific as well. Most compressive myelopathy presents with pain, and it's unusual to have cord compression without pain. But that's I can say with any reliability.
My Issues Began after A Shot With Vaccine As I Was In Middle School years. Immediately entered Unconscious to The Hospital. Muscle Wasting every year after that.