A few thoughts that occured to me and some friends...

[Nuno]

See the profile

[This message has been edited by Nuno (edited 19 May 2000).]

[Paddy]

Nuno:
Do my Neurology exam for me please?

(momentary lapse of thought)

The damage to your spinal cord would have to be below c3 (phrenic) but above c5 (brachial plexus) right?

What about a bilateral infarct of the internal capsule? (however improbable)

[Paddy]

Dimitri,

I have an eight pack (or would if you could see pass the beer)

[DentyCracker]

Yes Patrick, the damage would have to at least partially spare the phrenic (diaphragmatic) nerve but affect fully the nerves to biceps, triceps, deltoids and below. As everyone has slightly different anatomy the exact cervical nerves vary. Just check out your neuro books, btw which ones do you use, I can't even remember which ones I did.

[deabru]

Ba nere ustez nekezaua da euskera finish-a baino. Gaiñera ze berbakera dok hori, foto finisha? Ai ama zelako tontokerixa pillua esaten nabillen, eskerrak hemen iñobezek eztakila euskeraz.

Rowan:Euskera is the MOST difficult language in the world (i hardly understand myself)

[Rowan]

Hollanti on kyllä yksi vitun outo kieli. Onko täällä muuten muita suomalaisia? Ja minkä takia hollantilaiset tuntuvat hallitsevan koko tätä paikkaa? Tässä on takana joku salaliitto, vai?
No ei vaiskaan. Ihan hauskaahan se on kun on vähän kansainvälistä tunnelmaa.

Interesting tidbit: Finnish is the 3rd most difficult language in the world.

[Nuno]

Yes Patrick, a big A+ for you
Althought a bilateral infarct of the internal capsule is really highly improbable. For what I´ve seen, a acute cerebral infarct is mainly one vessel dependant (most frequently a MCA dependent). Yes, two consecutive cerebral infarcts could occur, but frankly speaking, usually they result in death rather than anything else.

How is your medical course in there? How many years?

And I realized Patrick is a medical student, but what is your field, DentyCracker?

[Helevitia]

I have a couple of questions:

1. What is the difference between 'acute myelitis' and transverse myelitis?

2. If a limb is considered 'spastic', what are the causes of this symptom? Is it a problem with just an injury to the spinal cord or does it have something to do with some sort of brain damage(ie; popped blood vessel, etc...)? or is it both?

3. What is the longest amount of time it takes for nerves to heal after an accident? I've heard up to 2 years.

Dave

[Nuno]

Transvers myelitis is an acute (or sub-acute) inflamatory disease of the spinal cord whose simptoms are focal pain in neck, back, parastesic sensations, sensorial loss, motor loss and sfincter abnomalities.
It´s associated with viral infections or even vaccination

[Paddy]

1.
As far as i know, acute myelitis is inflammation of the myelin sheaths surrounding neurones. I have never heared of transvers myelitis though.


2.
Signs of Upper motor neurone lesions (spinal cord and nerves)

Muscle weakness (if the lesions e.g. a pyramidal lesions occurs above the decussation) on the contralateral side. For long tract lesion due to spinal damage the weakness may be ipsilateral but more often is bilateral.

Increase in muscle tone (spasticity) because the inhibitory effect of the corticospinal tract is removed. As the upper limb flexors are stronger than the extensors, the arms tend to flex. In the lower limb extensors tend to predominate.
The increase in tone is characterised by changes in the resistance to passive movement - giving a 'clasp knife' or 'cog wheel' effect.

Hyperreflexia: The "damping" effect of the corticospinal tracts upon reflex acitivity in the PNS is removed so reflexes are exaggerated. Flexor reflexes predominating in the upper limb and extensor responses in the legs. In consequence the plantar response of the foot becomes extensor. This means that when the sole of the foot is stimulated the normal plantar flexion is replaced by a dorsiflextion of the foot and a fanning of the big toe (a positive Babinski sign).

Spasticity. Like hyperreflexia, spasticity arise from a loss of an inhibitory effect of higher motor centres.

A positive Babikski sign where the normal curling of the toes and plantar reponse to a stimulus applied to the sole is replaced by an extension of the toes an dorsiflexion of the foot. The sign of Bing is also present, i.e. when a pin is used to stab the dorsum of the foot the normal reaction, to extend the foot away from the pin, is replaced by a flexion which drives the pin into the foot.

Signs of Lower motor neurone lesions (spinal cord and nerves)

Muscle weakness - (paresis)

Muscle wasting

Fasciculation: flickering contractions of a muscle which can be seen through the skin

Areflexia: absence of reflexes

Hypotonia: marked reduction of muscle tone to give a flaccid muscle


3.
As far as i know, the only way a nerve can heal is if the damage occurs to the axon only. If so, then the longest time for a nerve to heal would be directly proportional to the lenth of the axon. The sciatic nerve is the longes nerve in your body, but even then i think that 2 years is very optimistic.
To be honest i dont think anyone really knows.
I have read studies about manipulating germ cells to try and get them to differentiate into neurones, but i wouldn't hold your breath.
I think that the trick is not to damage it in the first place!


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Sorry if there is too much info (got a bit carried away!) - anything to stop working!