Sensations pertaining to lateral columns and
dorsal columns were intact throughout, with no dissociation.
This lesion demonstrated restricted diffusion on the DWI sequence and involved the anterior gray, lateral gray and lateral funiculus of the right hemicord with sparing of the
dorsal columns (Figure 3).
In PSCI the
dorsal columns, dorsal horns, and posterior portion of lateral columns are affected [8]; however patients can have selective clinical presentations including loss of vibration and proprioception, segmental deep tendon areflexia, and weakness below the level of the lesion [9].
The DRG is a cluster of cells inside the dura that transmits sensory information, including nociceptive signals, to the
dorsal columns of the spinal cord.
[7,9] SCS activates the inhibitory effect of large primary afferent neurons in the
dorsal columns, damping the incoming pain signal.
* Although cerebellar damage also has to be considered, it is more likely that this patient's balance issues are connected with nerve damage to her
dorsal columns resulting in a loss of proprioception in her feet.
Severe attenuation or abolishment of all SEPs occurs in primates when the
dorsal columns of the upper thoracic, or mid cervical aspects of the spinal cord are ablated.
Dorsal columns and demyelinated regions were delineated using cryostat-sectioned tissue stained with eriochrome cyanine R for myelin.
Damage to the
dorsal columns results in ipsilateral loss of proprioception and fine touch below the level of the lesion.
Sparing of the
dorsal columns was evident from preservation of deep touch, proprioception and vibration sense in all limbs.
Some of the clinical manifestations associated with vitamin [B.sub.12] deficiency are 1) Hematologic: megaloblastic anemia and pancytopenia (leucopenia, thrombocytopenia); 2) Neurologic: paresthesias, peripheral neuropathy, and combined systems disease (demyelination of
dorsal columns and corticospinal tract); 3) Psychiatric: irritability; personality change; mild memory impairment, dementia; depression; and psychosis; and 4) Cardiovascular: possible increased risk of myocardial infarction and stroke.