Functional Localisation Flashcards
What are some features of central nervous system lesions?
Hemi/paraplegia or whole limb affected
Heaviness of limbs with spasms/jerks
Sensory symptoms and cognitive/sphincter involvement
What are some features of peripheral nervous system lesions?
Peripheral/localised area, or whole limb affected
Ascending weakness in certain positions or sleeping
Cramp and twitching with prominent pain
Loss of grip, tripping up and unsteady with eyes shut
What are some features of NMJ lesions?
Proximal limb affected, ocular or bulbar
Fatiguable weakness but not sensory features
Swallowing and speaking difficulties, ptosis, diplopia
Lots of chewing, prolonged gaze, occur later in day
What are some features of muscle lesions?
Proximal and symmetrical involvement
Aching and insidious weakness
Myalgia and cramp, but no sensory involvement
Difficulty getting up from chairs
What is seen on examination of patients with CNS lesions?
Inspect limb posture = increased tone with spasticity
Pyramidal pattern of weakness
Increased reflexes and extensor plantar response
Hemisensory involvement
What is seen on examination of patients with PNS lesion?
Wasting and pes cavus, decreased tone
Distal weakness and decreased reflexes
Flexor or mute plantar response
Glove and stocking or dermatomal sensory involvement
What is seen on examination of patients with NMJ lesions?
Ptosis, tone the same or decreased
Fatiguability with decreased or normal reflexes
Flexor plantar response and no sensory involvement
Normal or decreased tone
What is seen on examination of patients with muscle lesions?
Proximal wasting with decreased or normal tone
Diminished or normal reflexes
Symmetrical proximal weakness
Flexor plantar response and no sensory involvement
How do you demonstrate fatiguable weakness?
Bulbar = counting out load Ptosis = fixed upgaze Ocular = fixed horizontal gaze Limb = repetitive movement
What are some causes of central lesions of the brain?
Infarct, multiple sclerosis or tumour
What are some causes of central lesions of the spine?
Compressive, multiple sclerosis or transverse myelitis
What is the most common pathology of the NMJ?
Myaesthenia gravis = ocular features
Lambert Eaton = dry mouth, dizziness on standing
