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0 user entriesBasic Neuropathology 9Topic:  ImagingCreated on Monday, February 25 2013 by gliageek Last modified on Wednesday, February 27 2013. A)  Amyotrophic lateral sclerosis
         B)  Subacute combined degeneration
         C)  Tabes dorsalis
         D)  Pellagra
         E)  Multiple sclerosis
The pathological changes seen within this myelin stained section of spinal cord are most consistent with which of the following diagnoses? This question was created on February 25, 2013 by gliageek. This question was last modified on February 27, 2013.
                                           ANSWERS AND EXPLANATIONS
 A)  Amyotrophic lateral sclerosis
 This answer is correct.
Symmetrical degeneration of corticospinal axons occurs secondary to degeneration of cerebrocortical motor neurons in ALS. When axons degenerate, myelin will secondarily be lost. The resulting reactive astrocytosis produces a firm scarlike alteration in the lateral (and anterior) corticospinal tracts or "lateral sclerosis".
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 B)  Subacute combined degeneration
 This answer is incorrect.
Subacute combined degeneration demonstrates preferential damage to the posterior ascending fiber tracts, often with multifocal incomplete corticospinal tract damage.
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 C)  Tabes dorsalis
 This answer is incorrect.
As the name implies, tabes dorsalis is characterized by preferential dorsal degeneration of the spinal cord (secondary to Huebner�s arteritis).
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 D)  Pellagra
 This answer is incorrect.
Pellagra, which occurs secondary to riboflavin deficiency, is characterized by chromatolytic changes within anterior horn cells.
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 E)  Multiple sclerosis
 This answer is incorrect.
Demyelinating plaques of multiple sclerosis are never confined to anatomically defined tracts
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         References:
 
| 1.  van der Graaff, M.M., Sage, C.A., Caan, M.W., Akkerman, E.M., Lavini, C., Majoie, C.B., Nederveen, A.J., Zwinderman, A.H., Vos, F., Brugman, F., van den Berg, L.H., de Rijk, M.C., van Doorn, P.A., Van Hecke, W., Peeters, R.R., Robberecht, W., Sunaert, S., and de Visser, M.  (2011).  "Upper and extra-motoneuron involvement in early motoneuron disease: a diffusion tensor imaging study."  Brain, 134(Pt 4) 1211-28. (PMID:21362631) |  |  
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 FrontalCortex.com -- Neurology Review Questions -- Neurology Boards -- Board Review -- Residency Inservice Training Exam -- RITE Exam Review imaging
 Basic Neuropathology 9
 Question ID: 022513104
 Question written by gliageek. (C) FrontalCortex.com 2006-2009, all rights reserved.
Created:  02/25/2013
 Modified: 02/27/2013
 Estimated Permutations: 120
 
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