1.3. TYPES OF SENSORY LOSS - Pain Clinic

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1.3. TYPES OF SENSORY LOSS

Science and education > Handbooks > Neurological examination and topical diagnosis > Section I. Clinical examination and impairment symptoms of the nervous system function > Chapter 1. General Sensitivity: Examination techniques and impairment symptoms

1.    Lesion of the primary sensory cortex (postcentral gyrus) leads to contralateral monoanesthesia.

2.    Lesion of the posterior limb of internal capsule leads to contralateral hemianesthesia.

3.    Lesion of the thalamus leads to contralateral hemianesthesia and thalamic pain syndrome (Dejerine–Roussy syndrome).

4.    Lesion of the medulla oblongata leads to alternating hemianesthesia/crossed hemianesthesiaLoss of pain and temperature sensitivity on same side of the face as that of the lesion and on torso and limbs of the opposite side.

5.    Lesion of the posterior funiculus of the spinal cord leads to loss of deep sensitivity on the same side as that of the lesion. Superficial sensitivity is preserved. Lesion in the lateral funiculus of the spinal cord leads to loss of pain and temperature sensitivity on the opposite side of the lesion, 1-3 dermatomes below as that of the lesion. Deep sensitivity is preserved.

6.    Lesion of the posterior funiculus of the spinal cord leads to ipsilateral loss of pain and temperature sensitivity at the level of one or multiple dermatomes below as that of the lesion. Deep sensitivity is preserved.

7.    Lesion of the posterior root of the spinal cord leads to all types of sensitivity loss in the multiple dermatomes, including the dermatome at the level of the radix. 

8.    Lesion of the dorsal spinal ganglion leads to all types of sensitivity loss, trophic changes in form of papular rashes and pain at the level of dermatome corresponding to the lesion.

9.    Lesion of a single nerve leads to all types of sensitivity loss along its zone of innervation – mononeurotic type of sensitivity disorder.

10. Lesion of the peripheral nerves leads to all types of sensitivity loss in the distal part of the limbs - “gloves” and “stocking” type - polyneurotic type of sensitivity disorder.

11.  Lesion in the single tract of the spinal cord which involves selective loss of fine touch and proprioception without loss of pain and temperature, or vice-versa is  - dissociated sensory loss.

12. Lesions in the several adjacent segments of the thoracic spinal cord – loss of sensitivity in the form of "jacket" or "half-jacket" – Segmental-dissociated type of sensitivity disorder.

13.  Ipsilateral loss of deep and complex sensitivities below the level of the spinal lesion; contralateral loss of superficial sensitivity, 1 or 2 segments below the level of the lesion and loss of all sensitivities at the level of lesion - Dissociated-conductive type of sensitivity disturbance. This type of sensory defect is seen in incomplete lesion (hemisection) of the spinal cord. (Dissociated-conductive type of sensitivity disturbance along with ipsilateral spastic paralysis below the level of the lesion is called Brown-Sequard syndrome)

 

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