A 30-year-old window-washer fell from her ladder and injured her back at the T11-T12 level. She had bilateral flaccid paralysis of the legs and was rushed to the hospital, where she was observed for a few days. In an examination completed a few weeks later, she demonstrated the following symptoms:

1. Spastic paralysis in the left leg

2. Positive Babinski sign in the left leg

3. Loss of position sense (proprioception) and discriminative touch in the LEFT leg

4. Loss of pain and temperature in the RIGHT foot

How can you relate these symptoms to a crushed cord at the T11-T12 level?

Question

Biology

Wood

5 October, 13:40

A 30-year-old window-washer fell from her ladder and injured her back at the T11-T12 level. She had bilateral flaccid paralysis of the legs and was rushed to the hospital, where she was observed for a few days. In an examination completed a few weeks later, she demonstrated the following symptoms:

1. Spastic paralysis in the left leg

2. Positive Babinski sign in the left leg

3. Loss of position sense (proprioception) and discriminative touch in the LEFT leg

4. Loss of pain and temperature in the RIGHT foot

How can you relate these symptoms to a crushed cord at the T11-T12 level?

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Answers (1)

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Savanna Shah · Answer 1

The correct answer is 1.

Explanation:

Normally, when an acute spinal cord compression occurs, the patient develops bilateral flaccid paralysis, anesthesia and lack of sphincter below the level of lesion.

In subacute or chronical compression, the symptoms may appear separately (first pain, then sensitive and motor, then sphincter).

After acute flaccid paralysis, patients develop spastic paralysis, depending on the site of the lesion the symptoms will defer.

In this case, T11-T12 lesion can cause pain in the intercostal area (uni or bilateral), spastic paralysis of the legs, lack of sensitivity in thorax or pelvis area, scoliosis (because of interspinal muscle atrophy), urinary retention and sexual disfunction.