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- Gait dysfunction and sensory ataxia due to a combination of proprioceptive defects, hypertonicity, and weakness.
- Deep sensation defects in severe disease involving proprioception and vibration sense, due to posterior column compression.
- Paraesthesias and numbness.
- Compression of pyramidal and extra pyramidal tracts causing spasticity, weakness, and abnormal muscle contraction.
- Lower limb stiffness and dragging feet
- Upper limb fine motor control deficits
- Upper limb symptoms may be more prominent intermittently due to central cord compromise
- Urinary incontinence in long standing disease
- Neck pain may be a feature but is not normally prominent, and does not tend to occur early unlike cervical radiculopathy
- Upper motor neurone pattern abnormalities in the lower limbs, and lower motor neurone abnormalities in the upper limbs
- Special Tests
- Lhermittes sign (electric shock down torso on neck flexion)
- Foot tapping test
- Hand clenching test
- With back against the wall, unable to extend head back to touch the wall.
- Hoffman test, facilitated by cervical extension
MRI is best. Severe cord atrophy suggests a poor prognosis.
- Amyotrophic lateral sclerosis
- Multifocal motor neuropathy
- Multiple sclerosis
- Peripheral neuropathy