Spinal Cord Syndromes

Anterior cord syndrome

Lesions disproportionately affecting the anterior spinal cord, commonly due to infarction (eg, caused by occlusion of the anterior spinal artery)

Malfunction of all tracts except the posterior columns, thus sparing position and vibratory sensation

Brown-Séquard syndrome (rare)

Unilateral spinal cord lesions, typically due to penetrating trauma

Multiple sclerosis

Ipsilateral paresis

Ipsilateral loss of touch, position, and vibratory sensation

Contralateral loss of pain and temperature sensation*

Central cord syndrome affecting the thoracic spinal cord

Lesions affecting the center of the thoracic spinal cord, mainly central gray matter (including spinothalamic tracts, which cross), commonly due to trauma, syrinx, or tumors in the central spinal cord

Paresis tending to be more severe in the upper extremities than in the lower extremities and sacral regions

Severe in lower extremities and sacral regions, sparing upper extremities

Conus medullaris syndrome

Lesions around L1

Distal leg paresis

Perianal and perineal loss of sensation (saddle anesthesia)

Erectile dysfunction

Urinary retention, frequency, or incontinence

Fecal incontinence

Hypotonic anal sphincter

Abnormal bulbocavernosus and anal wink reflexes

Transverse myelopathy

Lesions affecting all or most tracts of the spinal cord at ≥ 1 segmental levels

Deficits in all functions mediated by the spinal cord below the level of the lesion (because all tracts are affected to some degree)