阿摩線上測驗
70. 脊髓損傷病人理學檢查發現四肢癱瘓合併痛覺和溫度感覺下降，且上肢比下肢嚴重，
最有可能的診斷為何？
(A) anterior cord syndrome
(B) posterior cord syndrome
(C) Brown-Sequard syndrome
(D) central cord syndrome
答案：登入後查看
統計： A(233), B(115), C(152), D(1150), E(0) #2023301
統計： A(233), B(115), C(152), D(1150), E(0) #2023301
詳解 (共 2 筆)
chris
#5648880
前索症候群(anterior cord syndrome)
脊髓前部損傷(damage to the front of the spinal cord)，造成損傷平面以下的運動和痛、溫覺喪失(resulting in impaired movement, touch, pain, and temperature sensations below the point of injury)；因脊髓後柱無損傷，故本體感覺存在；四肢癱瘓，下肢重於上肢In most cases of anterior cord syndrome, some movement can later be recovered。
中索症候群(central cord syndrome)
脊髓中央部病變使前聯合受損，表現雙側對稱性節段性分離性感覺障礙(resulting in loss of function in the arms, but some leg movement is preserved)。上肢運動神經偏於脊髓中央，而下肢運動神經偏於脊髓外周，當脊髓中央損害先時，然後再向外周擴展，因此，常造成上肢障礙比下肢明顯。
後索症候群(posterior cord syndrome)
傷及脊髓後部(damage to the back of the spinal cord)，造成損傷平面以下本體感覺喪失，而運動和痛、溫覺存在(maintain good muscle power, pain, and temperature sensation, but experience poor coordination)。此症在脊髓損傷中最少見。
布朗塞卡氏症候群(Brown-Séquard syndrome)
為一側脊髓損傷(one side of the spinal cord is damaged)。表現病變平面以下對側痛、溫覺喪失，同側深感覺喪失及上運動神經元癱瘓(loss of movement but preserved sensation on one side of the body, while the other side of the body has loss of sensation but preserved movement)
馬尾症候群(cauda equina syndrome)
第一~二腰椎損傷所致(injury to the nerves located between the first and second lumbar region of the spine)，出現感覺障礙：雙下肢及會陰部麻木、感覺
脊髓前部損傷(damage to the front of the spinal cord)，造成損傷平面以下的運動和痛、溫覺喪失(resulting in impaired movement, touch, pain, and temperature sensations below the point of injury)；因脊髓後柱無損傷，故本體感覺存在；四肢癱瘓，下肢重於上肢In most cases of anterior cord syndrome, some movement can later be recovered。
中索症候群(central cord syndrome)
脊髓中央部病變使前聯合受損，表現雙側對稱性節段性分離性感覺障礙(resulting in loss of function in the arms, but some leg movement is preserved)。上肢運動神經偏於脊髓中央，而下肢運動神經偏於脊髓外周，當脊髓中央損害先時，然後再向外周擴展，因此，常造成上肢障礙比下肢明顯。
後索症候群(posterior cord syndrome)
傷及脊髓後部(damage to the back of the spinal cord)，造成損傷平面以下本體感覺喪失，而運動和痛、溫覺存在(maintain good muscle power, pain, and temperature sensation, but experience poor coordination)。此症在脊髓損傷中最少見。
布朗塞卡氏症候群(Brown-Séquard syndrome)
為一側脊髓損傷(one side of the spinal cord is damaged)。表現病變平面以下對側痛、溫覺喪失，同側深感覺喪失及上運動神經元癱瘓(loss of movement but preserved sensation on one side of the body, while the other side of the body has loss of sensation but preserved movement)
馬尾症候群(cauda equina syndrome)
第一~二腰椎損傷所致(injury to the nerves located between the first and second lumbar region of the spine)，出現感覺障礙：雙下肢及會陰部麻木、感覺
喪失；括約肌功能障礙：尿瀦留、大小便失禁、陽痿。
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