10: Pattern recognition in neurological disease

Question 1

It is important to ___ the lesion in any patient with a neuro problem.

Answer 1

localise

Question 2

Where can problems be found in neuro disease?

Answer 2

Brain itself

Spinal cord

UMN, LMN if a motor problem

Sensory neurons

NMJ

Muscle itself…

Question 3

Muscle weakness can be either ___ or ___.

Answer 3

focal, generalised

Question 4

Muscle paralysis affecting several or all of the limbs indicate the problem is (focal / generalised).

Answer 4

generalised

Question 5

Which muscles in the head and neck must be affected by a motor problem to call it truly global?

Answer 5

Bulbar muscles

Question 6

The muscle weakness seen in myaesthenia gravis is initially ___ and becomes ___.

Answer 6

focal > generalised

Question 7

update UMN / LMN signs table

Question 8

In UMN diseases, the deep tendon reflexes tend to be brisk.

In which acute situation would they be absent?

Answer 8

Spinal shock

Reflexes temporarily lost below level of injury

Question 9

What are some examples of sensory weakness seen in UMN disease?

Answer 9

-paresis

hemi, quadri…

Question 10

umn vs lmn summary - useful

Question 11

NMJ disease e.g Lambert-Eaton syndrome and myaesthenia gravis present with (motor / sensory) symptoms.

Answer 11

motor symptoms only

Question 12

Which type of stroke causes contralateral leg weakness?

Answer 12

Anterior circulation stroke

Question 13

Which type of stroke causes contralateral arm, head and neck muscle weakness?

Answer 13

Middle cerebral artery stroke

Question 14

Muscle weakness below the level of an injury is characteristic of which location of lesion?

Answer 14

Spinal cord

Question 15

Diseases affecting which location cause purely fatiguable muscle problems?

Answer 15

NMJ

Question 16

integrate dermatomes, myotomes and exams