Sensory symptoms often include paresthesias; may begin in one or both feet and ascend. Sensory level to pin sensation or vibration often correlates well with location of transverse lesions. May have isolated pain/temperature sensation loss over the shoulders (“cape” or “syringomyelic” pattern) or loss of sensation to vibration/position sense on one side of the body and pain/temperature loss on the other (Brown-Séquard hemicord syndrome).

Motor symptoms are caused by disruption of corticospinal tracts that leads to quadriplegia or paraplegia with increased muscle tone, hyperactive deep tendon reflexes, and extensor plantar responses. With acute severe lesions, there may be initial flaccidity and areflexia (spinal shock).

Autonomic dysfunction includes primarily urinary retention; should raise suspicion of spinal cord disease when associated with back or neck pain, weakness, and/or a sensory level.

Interscapular pain may be first sign of midthoracic cord compression; radicular pain may mark site of more laterally placed spinal lesion; pain from lower cord (conus medullaris) lesion may be referred to low back.