Sensory Level and Neuro-Imaging

Posted by Femi Daniel Femi Daniel
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Dear sir,

In theory, a sensory level noted after spinal cord injury should be a guide to the spinal segment involved (one or two above the level).

I have had to doubt the sensitivity of this clinical finding in determining the MRI request (Lumbo-scaral or Thoraco-Lumbar) when faced with paraparesis (especially flaccid).

Is this purely a reflection of my incompetence.. or is it a common problem?

Are there more definite features to look for so that one does not have to "guess"..?

I'll really appreciate some help here.

Femi Daniel

p.s. MRI is not a very cheap study where I work and missing the lesion just because one wasn't certain where to image is certainly not good news...

2 Comments

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Dr. Thamburaj Dr. Thamburaj
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Re: Sensory Level and Neuro-Imaging

Sensory level noted after spinal cord injury should be a guide to the spinal segment involved (one or two above the level) only when we suspect a spinal cord lesion (above L1 level) in case of UMN type paraparesis.

flaccid paraparesis is a LMN type.
If associated with bladder symptoms, the problem is likely to be in cauda equina (below T12 to S1)
Femi Daniel Femi Daniel
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Re: Sensory Level and Neuro-Imaging

In reply to this post by Femi Daniel
Thanks, Sir. That helps!