Localization in Neurology
Terms
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- Lower Motor Neuron Symptoms
-
1) Weakness/paralysis
2) Hypotonia
3) Hyporeflexia
4) Atrophy of muscles
5) Fasciculations - Upper Motor Neuron Symptoms
-
1) Weakness/paralysis
2) Hypertonia
3) Hyperreflexia
4) Abnormal reflexes (Babinski) -
CEBELLAR FUNCTIONS:
Archicerebellum, vestibular cerebellum, flocculonodular lobe. -
Balance
Eye movements -
CEREBELLAR FUNCTION:
Paleocerebellum, spinal cerebellum - muscle tone, adjusts ongoing movements
-
CEREBELLAR FUNCTION:
Neocerebellum, corticopontine cerebellum - coordination of skilled movements
- Decerebrate State
-
1) Lesion is between red nucleus and vestibular nucleus
2) Upper and Lower extremity extension and internal rotation
3) Release of inhibition and loss of flexor (rubrospinal) tone - Decorticate rigidity
-
1) Supratentorial lesion
2) Upper extremity flexion/adduction
3) Lower extremity extension, internal rotation
4) Due to loss of input from the cortex -
Spinal cord transection
(acute) -
"Spinal Shock"
1) Complete paralysis and anasthesia below the lesion
2) Temporary areflexia -
Spinal cord transection
(chronic) -
1) Complete paralysis and anasthesia below the lesion
2) Hyperreflexia (upper motor neuron injury) - Central cord syndrome
-
1) Bilateral spinothalamic loss at the level of the lesion
2) Upper motor neuron paralysis affecting upper extremity MORE than lower extremity - Brown-Séquard syndrome
-
(Spinal cord hemisection)
IPSILATERAL:
1) Possible LMN paralysis at the level of the lesion (AHC)
2) Possible cutaneous anasthesia at the level of the lesion
3) UMN paralysis below the level of the lesion
4) Proprioceptive loss below the level of the lesion
CONTRALATERAL:
1) Pain and temp loss below the level of the lesion - Anterior cord syndrome
-
BILATERAL:
1) Upper motor paralysis below the level of the lesion
2) Pain/temp loss below the level of the lesion
3) Relative sparing of proprioception below the level of the lesion - Cauda equina syndrome
-
(purely lower motor)
1) Saddle distribution
2) LMN paralysis below level of lesion (loss of bladder, bowel sphincter reflexes, lower limbs paralyzed) - Conus medullaris syndrome
-
(almost always a central lesion)
1) Includes injury to sacral cord and cauda equina
2) Usually LMN findings
3) May spare sacral reflexes!