A 50-year-old woman undergoes a neurologic exam that indicates loss of pain and temperature sensitivity, vibratory sense, and proprioception in the left side of the body. These symptoms could be explained by:
Loss of pain and temperature indicate lesion in Spinothalamic pathway. Loss of touch, vibration, and proprioception points towards lesion of Dorsal column (Medial lemniscus) pathway. Since dorsal column crosses in medulla while spinothalamic tract crosses in spinal cord, destruction of right postcentral gyrus will result in loss of pain, temperature, vibration, touch, proprioception on left side of the leg. Option A: Right sided lesion in dorsal column will result in loss of touch, vibration, and proprioception on the right side only, below the level of lesion. Pain and temperature sense should remain intact. Option B: Left medial lemniscus pathway lesion will result in loss of touch, vibration, and proprioception on the left side only, below the level of lesion. Pain and temperature sense should remain intact. Option D: Tumour in right ventrolateral spinal cord will affect ventrolateral tract that will result in loss of pain and temperature sensation on the left side below level of lesion. But proprioception and vibration will remain intact.
A tumour on the right medial lemniscal pathway in spinal cord
A tumour on the left medial lemniscal pathway in spinal cord
A tumour affecting the right postcentral gyrus
A large tumour in the right ventrolateral spinal cord
Sensory System