A 60-year-old male presents with sudden onset of complete paralysis below the waist, urinary incontinence, and severe back pain at the T10 level. He h...

Question

A 60-year-old male presents with sudden onset of complete paralysis below the waist, urinary incontinence, and severe back pain at the T10 level. He has no history of trauma. He has known atherosclerotic disease and recently had an abdominal aortic aneurysm repair. What is the most likely diagnosis?

Accepted Answer

Anterior spinal artery syndrome (spinal cord infarction) - the anterior spinal artery supplies the anterior two-thirds of the cord; occlusion causes motor paralysis and loss of pain/temperature sensation below the level, with preservation of proprioception and vibration (posterior column function)

Answer

Guillain-Barré syndrome

Answer

Epidural abscess causing cord compression

Answer

Transverse myelitis from viral infection

Answer

Cauda equina syndrome from disc herniation

uk-dipimc MCQ (SBA): Anterior Spinal Artery Syndrome