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Thread: Toes Movement

  1. #1
    Junior Member
    Join Date
    Oct 2001

    Toes Movement

    In 23/09/01 I posted here indicating my dad had a road traffice accident resulted (quoted from doctor)Principal diagnosis: Cervical spine flexion/extension injury.Secondary diagnosis-1)cervical spondylosis 2) hypertension 3) recurrent UTI.Cervical cord injury C4/5 Cx by spinal shock. Has bradycardia s/b CVM;2D echo norm. CT Thorax-lung contusion. MRI C spine-cord edema C4 level.Has Power 2 at C5 bilateral and zero below. Currently he his back home and breathes normally without aid. 2 days back I was pleasantly surprised when he managed to wriggle all his left toes with his control. The toes move up and down though not to their full extend. He has arm movement but no finger movements and his triceps and deltoids are rather tender.I was really surprised over the left toes movement though right toes are still not moving. I spoke to my physio and she wants me to consult the spinal consultants for re-admitting to hospital. Currently he goes twice a week for rehab at an old folks place for SCI's and strokes patients. Would Dr Young or anyone else clarify the toes movements?? Thanks a million and God bless.

  2. #2

    Central cord syndrome

    It is very likely that your father has what is called Central Cord Syndrome. This is one of the incomplete SCIs that are especially common in older people, often due to rather low velocity falls where the head is forced backwards (such as tripping and catching the chin on a chair).

    Because the part of the cord most damaged with this type of mechanism is in the center of the cord, and because the center of the cord controls the arms more than the legs, the person usually will have a picture of more paralysis in their legs than in their arms. If they have any movement in their arms, it tends not to be in the hands, although this can very.

    It is a good idea while your father is continuing to get return like this that he continue in therapy (both OT and PT) and be sure that any returning muscles receive appropriate strengthening either with FES (when very weak) or with traditional exercise (as they get stronger).
    At this point it is impossible to predict how much he will get back, but important to maximize what he does.


  3. #3
    james, I agree with KLD. Your father has central cord syndrome. If he was injured in September, this means that he is about 7 months post-injury. He still have recovery time ahead of him. Many people with central cord syndrome continue to recovery for two or more years, to gain strength in the legs and also get more of their arms and hands back. In my experience, older people tend to take longer to recover. Your father's situation was also complicated by his thorax-lung contusion and bradycardia which may have introduced a period of hypotension and low blood pressure during the acute phase of injury. I have know several people with central cord syndrome who have recovered motor function more than an year after injury and continued to do so for up to 3-4 years.

    I agree with KLD that he should get aggressive physical and occupational therapy.


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