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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

what weakness results from a hemispheric lesion

contralateral pyramidal weakness in face, arm, leg