Central cord syndrome most commonly presents with which pattern?

Central cord syndrome most commonly presents with which pattern?

• A. Greater upper extremity weakness than lower extremities
• B. Typically lower extremities more affected
• C. Sensory loss only
• D. Proprioception preserved

Answer: (A)

Central cord syndrome is a cervical spinal cord injury that preferentially disrupts the fibers serving the arms more than the legs. In the cervical region, the fibers controlling the upper limbs are more central, so a central injury hits them first, producing greater weakness in the arms than in the legs. You often see a “cape-like” pattern of pain and temperature loss over the shoulders and arms from spinothalamic involvement, while the legs may be less affected. Proprioception and vibration are often relatively preserved because the dorsal columns are less involved, which helps explain why sensory loss isn’t the sole feature. So, the defining pattern is stronger weakness in the upper extremities compared with the lower extremities. The other options don’t fit that typical distribution: lower extremity predominance would point away from central cord injury; sensory loss only ignores the motor component; and while proprioception can be preserved, the key hallmark is the disproportionate arm weakness.

Central cord syndrome is a cervical spinal cord injury that preferentially disrupts the fibers serving the arms more than the legs. In the cervical region, the fibers controlling the upper limbs are more central, so a central injury hits them first, producing greater weakness in the arms than in the legs. You often see a “cape-like” pattern of pain and temperature loss over the shoulders and arms from spinothalamic involvement, while the legs may be less affected. Proprioception and vibration are often relatively preserved because the dorsal columns are less involved, which helps explain why sensory loss isn’t the sole feature.

So, the defining pattern is stronger weakness in the upper extremities compared with the lower extremities. The other options don’t fit that typical distribution: lower extremity predominance would point away from central cord injury; sensory loss only ignores the motor component; and while proprioception can be preserved, the key hallmark is the disproportionate arm weakness.