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Myelopathy is a disorder within the spinal cord. Compression on the spinal cord by bony projections or a displaced disk in the cervical spine are the most common causes of myelopathy. [7] Inflammation, illness, and neurodegenerative, nutritional, and vascular disorders can also contribute to myelopathy.
Exaggerated (brisk) deep tendon reflexes such as this can be found in upper motor neuron lesions, hyperthyroidism, [6] anxiety or nervousness. The test itself assesses the nervous tissue between and including the L2 and L4 segments of the spinal cord. [1] The patellar reflex is often tested in infants to test the nervous system. [7]
Multifocal motor neuropathy (MMN) is a progressively worsening condition where muscles in the extremities gradually weaken. The disorder, a pure motor neuropathy syndrome, is sometimes mistaken for amyotrophic lateral sclerosis (ALS) because of the similarity in the clinical picture, especially if muscle fasciculations are present.
Usually, in this case, motor function of the lower leg will not be impaired. This is a key distinction between saphenous nerve neuropathy and lower back radiculopathy. Saphenous nerve neuropathy only demonstrates sensory alterations, while lumbar radiculopathy will affect the motor, sensory, and deep tendon reflexes of the lower leg. [6]
In general, distal hereditary motor neuropathies affect the axons of distal motor neurons and are characterized by progressive weakness and atrophy of muscles of the extremities. [1] It is common for them to be called "spinal forms of Charcot-Marie-Tooth disease (CMT)", because the diseases are closely related in symptoms and genetic cause.
Patients with hereditary motor and sensory neuropathies are diagnosed through a physical evaluation that looks for muscle atrophy, weakness, and sensory responses. [3] In addition to this, electromyography and motor nerve conduction tests can help clinicians decide what type of motor and sensory neuropathy it is and how severe the disease is.
The suprascapular nerve is a mixed (sensory and motor) nerve that branches from the upper trunk of the brachial plexus. It is derived from the ventral rami of cervical nerves C5-C6. It provides motor innervation to the supraspinatus muscle , and the infraspinatus muscle .
There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]