Which spinal cord syndrome is characterized by preserved function in the lower extremities but weakness or paralysis and loss of pain sensation in the upper extremities?

• A. Brown-Sequard syndrome
• B. Anterior cord syndrome
• C. Spinal shock
• D. Central cord syndrome

Answer: (D)

This pattern highlights how central injuries to the cervical spinal cord produce more weakness in the arms than in the legs. When the central portion of the cervical cord is damaged, the fibers that control the arms and the spinothalamic fibers carrying pain and temperature sensation crossing near the center are affected first. The result is weakness or paralysis in the upper extremities with loss of pain sensation in those same areas, while the lower extremities remain relatively preserved initially.

This differs from other syndromes: Brown-Sequard would show a mix of ipsilateral motor and vibration loss with contralateral pain and temperature loss; anterior cord syndrome would cause motor and pain/temperature loss below the lesion with preserved vibration and position sense; spinal shock is an acute, temporary phase with widespread loss of function below the injury that gradually improves.