A patient has damage to the lateral corticospinal tract at C5 on the right side. Which pattern of deficits would be expected?

• A Contralateral UMN signs below C5 AND contralateral loss of all sensory modalities below C5
• B Ipsilateral LMN signs at C5 level with no sensory loss
• C Ipsilateral UMN signs below C5 AND ipsilateral loss of fine touch and proprioception below C5 AND contralateral loss of pain and temperature below C5 ✓
• D Bilateral UMN signs and bilateral sensory loss below C5

Explanation

Right lateral C5 cord damage produces Brown-Séquard syndrome: (1) Ipsilateral (right) UMN signs below C5 — lateral corticospinal tract is already crossed; (2) Ipsilateral (right) loss of tactile discrimination, vibration, and proprioception — dorsal column is ipsilateral; (3) Contralateral (left) loss of pain and temperature from below C5 — spinothalamic tract has already crossed 1–2 segments above its entry level. LMN signs would occur at the level of injury (C5 segment) ipsilaterally due to anterior horn damage.

Reference: Guyton & Hall, Textbook of Medical Physiology, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.