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Related Experiment Videos

Hyperpathia in the central cervical cord syndrome.

A Hopkins, P Rudge

    Journal of Neurology, Neurosurgery, and Psychiatry
    |August 1, 1973
    PubMed
    Summary

    Central cord syndrome, often from cervical spine injury, causes greater upper limb weakness. This study highlights severe shoulder and arm pain as a key symptom, even in mild cases, challenging previous anatomical explanations.

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    Area of Science:

    • Neurology
    • Neurosurgery
    • Spinal Cord Injury

    Background:

    • Central cord syndrome is a clinical entity resulting from hyperextension or flexion injuries to the cervical spinal cord.
    • Characterized by disproportionately greater weakness in the upper limbs compared to the lower limbs.
    • Previous hypotheses regarding the anatomical basis for this pattern, such as lateral lamination of corticospinal tracts, are questioned.

    Purpose of the Study:

    • To describe the clinical presentation of central cord syndrome in a series of patients.
    • To investigate the characteristic pattern of neurological deficits, particularly the relative sparing of lower limb function.
    • To analyze the prevalence and nature of associated symptoms, such as pain.

    Main Methods:

    • Case series describing seven patients with hyperextension or flexion injuries to the cervical cord.
    • Clinical examination to assess neurological deficits, including limb strength.
    • Patient interviews to gather information on symptoms, including pain characteristics and onset.

    Main Results:

    • All seven patients presented with symptoms consistent with central cord syndrome.
    • Upper limb weakness was more pronounced than lower limb weakness in all cases.
    • Six out of seven patients reported severe shoulder and arm pain, often unrecognized initially.

    Conclusions:

    • The findings support the characteristic presentation of central cord syndrome with upper limb-predominant weakness.
    • The study challenges the proposed anatomical explanation for the relative sparing of the legs.
    • Severe shoulder and arm pain is a significant and often overlooked symptom in central cord syndrome, requiring clinical attention.

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