Flashcards in Localising Lesions Deck (80)
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1
what are movement disorder features arise from lesions in the corticospinal/ pyramidal tracts
pyramidal/ UMN features:
pyramidal weakness (corticospinal distribution: hemiparesis, quadriparesis, paraparesis, monoparesis, faciobrachial)
spascticity
2
what are the types of movement disorders that arise from lesion in the basal ganlgia
(extrapyramidal)
hyperkinetic
- dystonia
- tics
- myoclonus
- chorea
- tremor
hypokinetic (rigidity and bradykinesia)
- parkinsonism
- parkinson's disease
3
what movement disorders arise from the cerebellum
ataxia
4
what makes up the peripheral nervous system
spinal nerve
root
plexus
peripheral nerves
5
what are the features of focal weakness
in distribution of peripheral nerve or spinal root
hemi-distribution (one side of body)
pyramidal distribution
6
what is pyramidal distribution weakness
where the extensors are weaker in the arms and the flexors are weaker in the legs
7
what are the features of non focal weakness
generalised
predominantly proximal or distal
if truely generalised will include bulbar motor function
8
UMN weakness:
distribution
corticospinal
-hemiparesis
-quadriparesis
-paraparesis
-monoparesis
- faciobrachial
9
LMN weakness:
distribution
generalised
predominantly proximal, distal or focal
no preferential involvement of corticospinal innervated muscles
10
UMN weakness:
Sensory loss
central pattern
11
LMN weakness:
Sensory loss
-can be none
-glove
-stocking
-peripheral nerve or root distribution
12
UMN weakness:
-deep tendon reflexes
-superficial reflexes
-pathological reflexes
deep- increased (unless very acute= flaccid)
superficial- decreased
pathological- increased
13
LMN weakness:
-deep tendon reflexes
-superficial reflexes
-pathological reflexes
deep- normal/ decrease
superficial- normal
pathological- normal
14
what are the superficial reflexes
plantar
gag/ swallow
cremasteric
corneal
15
what are the pathological reflexes
babinski (upward plantar, fanning and hyperextension of the toes), hoffmans etc
16
UMN weakness:
sphincter function
sometimes impaired
17
LMN weakness:
sphincter function
usually normal (except in cauda equina)
18
UMN weakness:
muscle tone
increased
19
LMN weakness:
muscle tone
decreased/ normal
20
UMN weakness:
muscle bulk
sometimes hypertrophy
21
LMN weakness:
muscle bulk
wasting
22
UMN weakness:
other CNS signs?
possibly
23
LMN weakness:
other CNS signs?
no
24
increased tone, brisk reflexes, pyramidal/ corticospinal pattern of weakness (= weak extensors in the arm, weak flexors in the legs) = ?
upper motor neurone pattern
25
wasting, fasciculation, decreased tone, decreased or absent reflexes, flexor plantars = ?
lower motor neurone pattern
26
what are the features of muscle disease
wasting (usually proximal)
decreased tone
decreased/ absent tendon reflexes
27
what are the features of NMJ weakness
fatiguable weakness
normal/ decreased tone
normal reflexes
NO SENSORY SYMPTOMS
28
what are the features of functional weakness
no wasting
normal tone
normal reflexes
erratic power
non anatomical loss
29
what causes UMN weakness
acute stroke syndromes
space occupying lesions
spinal cord problems
30
