PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.

Monday, April 24, 2006

Dissociated Sensory Loss

It is a useful generalization to state that pain/temperature sensation and touch/vibration/joint position sensation follow two distinct pathways.
1. Pain/temp in spinothalamic pathway
2. Touch/vibration/jt position in dorsal column

Damage to either pathway in isolation results in dissociated sensory loss. The damage usually occurs in the spinal cord.

1. Causes of spinotahlamic loss

  • Syringomyelia
  • Brown-Sequard syndrome - contralateral leg
  • Lateral medullary syndrome - contralateral to other signs
  • Anterior spinal artery thrombosis

2. Causes of doral column loss

  • Subacute degeneration of the spinal cord
  • Multiple sclerosis
  • Brown-Sequard syndrome - the ipsilateral leg
  • Tabes dorsalis
  • Spinocerebellar degeneration e.g. Friedreich's ataxia



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