Which syndrome does this BEST describe: loss of proprioception, vibration sense, and discriminative touch bilaterally below the level of injury, while motor function and pain/temperature are relatively intact?

Which syndrome does this BEST describe: loss of proprioception, vibration sense, and discriminative touch bilaterally below the level of injury, while motor function and pain/temperature are relatively intact?

• A. Posterior cord syndrome
• B. Central cord syndrome
• C. Anterior cord syndrome
• D. Brown-Séquard syndrome

Answer: (A)

The impaired modalities point to damage of the dorsal (posterior) columns, which carry proprioception, vibration, and discriminative touch. When these pathways are affected bilaterally below the injury, you lose position sense, vibration, and fine touch while motor function and pain/temperature pathways (the spinothalamic tract) stay relatively intact. This pattern is characteristic of posterior cord syndrome. Clinically, you’d expect poor Romberg performance due to loss of position sense, with preserved motor strength and intact pain and temperature sensation. Other syndromes would show different patterns: anterior cord syndrome typically has loss of motor function and pain/temperature with preserved proprioception; central cord syndrome often causes greater weakness in the upper extremities with variable sensory loss; Brown-Séquard syndrome produces ipsilateral motor and dorsal column loss with contralateral pain/temperature loss below the lesion.

The impaired modalities point to damage of the dorsal (posterior) columns, which carry proprioception, vibration, and discriminative touch. When these pathways are affected bilaterally below the injury, you lose position sense, vibration, and fine touch while motor function and pain/temperature pathways (the spinothalamic tract) stay relatively intact. This pattern is characteristic of posterior cord syndrome.

Clinically, you’d expect poor Romberg performance due to loss of position sense, with preserved motor strength and intact pain and temperature sensation.

Other syndromes would show different patterns: anterior cord syndrome typically has loss of motor function and pain/temperature with preserved proprioception; central cord syndrome often causes greater weakness in the upper extremities with variable sensory loss; Brown-Séquard syndrome produces ipsilateral motor and dorsal column loss with contralateral pain/temperature loss below the lesion.