Spinal cord lesions: topography and clinical syndromes

Topographic and clinical characteristics of spinal cord lesions caused by trauma and various diseases are described. Clinical localisation is based on the knowledge of functional anatomy and physiology. The author outlines clinical characteristics of systemic lesions of single tracts, intramedullar and extramedullar processes, and of complete and partial transverse lesions of the spinal cord. Transverse lesions cause paresis or paralysis of all, or only lower limbs associated with a loss of sensory functions below the level of lesion, and impairment of sacral functions. Chronic lesions above the conus are accompanied by spasticity. Clinical signs of segmental involvement indicate the level of the spinal cord lesion. Characteristics of clinical syndromes which depend on the level and site of spinal cord lesion are described.