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Sensory symptoms

Numbness and paresthesia are common and often so transient as to be forgotten. Paraesthesia is more often due to posterior column demyelination than to spinothalamic tract involvement.

/ Posterior column lesions result in impaired vibration ' sensation and joint position sensation. In such cases a limb may be rendered 'useless' by the absence of positional awareness.

Lhermitte's sign: with cervical posterior column involvement sudden neck flexion will evoke a 'shocklike' sensation in the limbs.

Spinothalamic lesions result in dysaesthesia - an unpleasant feeling of burning, coldness or warmth, with associated sensory loss to pain and temperature contralateral to the lesion.

A plaque at the posterior root entry zone will result in loss of all sensory modalities in that particular root distribution.

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