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Neuro - Weakness


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What are the potential places of central weakness?
cortical, subcortical, midbrain, pontine, medullary, spinal cord
What is the presentation of a small cortical lesion?
Monoplegia +/- sensory loss in the same area
What is the presentation of a large hemispheric lesion (MCA stroke)?
Weakness that affects the arm greater than the leg (face, arm > leg) as well as homonymous hemianopia, and hemisensory loss.
What is commonly seen in left-sided lesions?
What is commonly seen in right-sided lesions?
What is the presentation of ACA strokes?
Pronounced leg weakness and numbness with subtle mental status changes.
What is the presentation of a subcortical lesion?
Hemiparesis with the pattern of face=arm=leg +/- hemisensory loss, but SPARING OF VISION
Where are the lesions in neuronopathies?
In the anterior horn cell.
What are the characteristics of neuronopathies?
Pure motor disturbances with severe generalized weakness, wasting, hyporeflexia, and fasciculations.
Give 2 neuronopathies.
Describe ALS.
Amyotrophic Lateral Sclerosis - disorder characterized by upper and lower motor neuron pathology
Describe SMA.
Spinal muscular atrophy - class of infantile/juvenile, hereditary disorders of progressive weakness, muscle loss, hyporeflexia, etc. w/o UMN signs.
Describe radiculopathies
Nerve root disorders - sensorimotor disturbances (weakness and numbness ) in the distribution of one or more nerve roots, often associated with pain in the same root distribution and segmental hyporeflexia.
What usually causes radiculopathies?
Compressive disks, but can be tumors, diabetes, or CMV.
What disorder is characterized by weakness, numbness, hyporeflexia and pain of the entire limb?
What are some causes of plexopathies?
Diabetes (lumbar), cancer, Lyme disease (brachial), etc.
Guillan Barre demonstrates what type of weakness?
Proximal weakness.
What are 2 disorders of the neuromuscular junction?
Myasthenia Gravis
What are the 5 types of myopathies?
*muscular dystrophy
What class of agents are known for causing myopathies with increased CK?
What is medial medullary syndrome?
A medullary lesion produces hemiparesis SPARING THE FACE, ipsilateral tongue deviation and contralateral loss of vibration and proprioception.

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