Review Question - QID 106115

The patient's symptoms of progressive weakness in both lower extremities, numbness, tingling, hyperreflexia, upgoing Babinski sign, and decreased sensation below the level of the umbilicus are consistent with spinal cord compression.

Spinal cord compression occurs when there is pressure on the spinal cord, resulting in neurological deficits. Common causes include vertebral fractures, tumors, and disc herniation. The clinical presentation typically includes progressive weakness, sensory disturbances, hyperreflexia, and pathological reflexes such as an upgoing Babinski sign. Sensory deficits are usually present below the level of the lesion. Prompt diagnosis and intervention are necessary to prevent further neurological damage.

Incorrect Answers
Answer 1: Cauda equina syndrome typically presents with lower back pain, bilateral leg pain, saddle anesthesia, bowel and bladder dysfunction, and lower extremity weakness. It is characterized by compression of the nerve roots below the level of the conus medullaris, rather than the spinal cord itself.

Answer 3: Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that primarily affects peripheral nerves. It presents with ascending symmetrical weakness, areflexia, and sensory deficits. It does not involve spinal cord compression.

Answer 4: Lumbar disc herniation can cause radiculopathy, characterized by unilateral leg pain and weakness corresponding to the affected dermatome. It typically does not result in the progressive weakness, hyperreflexia, and other findings seen in spinal cord compression.

Answer 5: Multiple sclerosis is a chronic autoimmune demyelinating disease that primarily affects the central nervous system, including the brain and spinal cord. While it can cause sensory and motor deficits, the presentation is often relapsing and remitting, with symptoms occurring in different areas at different times. The progressive weakness, hyperreflexia, and other findings in this patient are not typical of multiple sclerosis.

Bullet Summary
Spinal cord compression presents with progressive weakness, sensory disturbances, hyperreflexia, and pathological reflexes. Prompt diagnosis and intervention are crucial to prevent further neurological damage.