INSCSCI #4

[haley.vitucci@gmail.com]

I am having trouble understanding the practice INSCSCI #4 (Right Motor Score) . If all of the muscle tests are 5/5 on the right side, why does the answer indicate T1 for the Right Motor Score?

[Chrissy Durrough Lugge]

Hi Haley!

Thanks for this question! This is one of the trickier concepts of the ASIA exam. Because there is no myotome testing for the trunk, we have to make assumptions about this region – and the ASIA is standardized to make conservative assumptions. In regions with no formal muscle test (T2-L1), motor function is presumed to be the same as sensory function if testable motor function above that level is also normal. So, even if motor scores are normal in all testable regions (upper and lower extremity), if sensation is impaired between T2 and L1, the motor level is the lowest level with intact sensation. This is also outlined in the “Steps in Classification” section on page 2 of the PDFs.
Let me know if you have any other questions!

Chrissy

[Tuong-Linh Vu]

Hey Chrissy,
Sorry, I am still confused why the right motor level is T1 and not C8? At T1, LT is a 2 and PP is a 0. The lowest level of intact sensation for both LT and PP is C8? Thank you in advance.

[Chrissy Durrough Lugge]

Hi Tuong-Linh,
There is a motor test for T1 that is 5/5. The motor score will trump sensation when determining motor level.
Chrissy

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