Central cord syndrome presentation at both levels typically shows deficits starting in which region and progressing to which region?

• A. Upper extremities to lower extremities
• B. Lower extremities to upper extremities
• C. Facial to trunk
• D. Proximal to distal

Answer: (A)

Central cord syndrome typically unfurls with greater weakness and sensory change in the arms first, then progresses to involve the legs. This happens because the central portion of the cervical spinal cord houses many fibers that control the upper limbs. When a central lesion occurs, those central fibers are hit before the pathways for the lower limbs, so deficits start in the upper extremities and can spread downward as the injury affects more of the cord. This upper-extremity–predominant involvement that progresses to the lower extremities is the hallmark pattern.