F- CLINICAL ASPECTS OF SPINAL CORD INJURIES
303
Incomplete cord lesions
The somatotopic arrangements of the sudomotor tract within the spinal cord explains
the segmental or regional type of thermal sweat disturbance in initially incomplete lesions
of the spinal cord. This is shown in a case of incomplete lesion of the mid-cervical cord
which demonstrates the thermoregulatory sudomotor disturbances over the right side
of the forearms, trunk and leg and also shows the dissociation to the disturbances of
sensibility (Fig. 132).
The somatotopic arrangements of the sudomotor tract also explain the scattered
segmental recovery of initially complete transverse lesions which, in incomplete cervical
lesions, might for instance, start first in the abdominal area on one side, before sudomotor
recovery takes place in other parts. This is shown in the case of a young man who had a
neuro-fibroma at the level of C5/6, which was removed by Professor Cairns in Oxford.
Before the operation there was a complete transverse spinal syndrome below €5 with a
lower motor neurone paralysis of the left deltoid and incomplete paralysis of the left
biceps in addition to complete sensory loss below C4 and loss of control of the bladder.
The thermoregulatory sweat test (Quinizarin technique) before the operation showed only
hypohidrosis in the face especially on the left side, and also some pin-points of sweat over
FIG. 133.
