Lesions Flashcards
Lesions of the medial lemniscus at any level will result in
Loss of fine touch and conscious proprioception of the opposite side of the body
Lesions of the spinothalamic tract at any level will result in
Loss of pain and temperature of the opposite side of the body
Hemisection of the spinal cord results in
Ipsilateral loss of fine touch and proprioception for the body (due to damage of dorsal columns)
Contralateral loss of pain and temperature for the body (due to damage of spinothalamic tracts)
Ipsilateral loss of fine touch and pain/temp may be seen at level of lesion due to damage to the dorsal roots
Ipsilateral loss of fine touch and proprioception for the body and contralateral loss of pain and temperature for the body is known as _ syndrome
Brown-Sequard Syndrome
Damage to the ventral medial medulla on one side causes
Loss of fine touch and conscious proprioception on the side of the body contralateral to the lesion
Damage to the lateral half of the rostral medulla results in _ syndrome
Wallenberg’s syndrome
Damage to the lateral half of the rostral medulla causes
Loss of pain and temp for Ipsilateral face and loss of pain and temp for contralateral body
Ipsilateral loss of pain and temp for the face and contralateral loss of pain and temp for the body is called _ syndrome
Wallenberg
Astereogenosis
May occur after damage to the parietal lobe in and around postcentral gyrus
Difficulty identifying items placed in hand if not allowed to use eyes
Due to damage of dorsal column medial lemniscal pathway leading to a. Loss of fine touch
Damage to superior parietal lobe- difficulty identifying objects
Damage to post central gyrus- difficulty discriminating size and shape of objects
Lesions of lower motor neurons causes _ paralysis
Flaccid (decreased tone and reflexes)
Damage to upper motor neurons causes _ paralysis
Spastic (increased tone and reflexes)
Rabies virus
Retrograde transport of rabies virus from peripheral nerves to LMN of the ventral horn of the spinal cord and to the CNS
Poliovirus
Pi coronavirus spreads from gut to spinal cord where it destroys neurons of the ventral horn of the spinal cord
Virus also kills LMN in the brainstem
Spinal Muscular Atrophy
Autosomal recessive neurodegenrative disease caused by loss of function mutation in caused by deletion of exon 7 in SMN1 gene (encodes survival motor neuron proteins)
Causes muscular atrophy due to a lack of input from lower motor neurons
Lesions of LMN causes
Paralysis
Amyotrophic Lateral Sclerosis (ALS)
Gain of function mutation in SOD1 gene causes degeneration of UMN and LMN
May have UMN signs (spasticity) and/or LMN signs (fasciculations, muscle atrophy)
Patient can wrinkle forehead of both sides
Right lower face droops
Central facial palsy
UMN loss
L corticobulbar tract lesion
Patient can wrinkle forehead on left side only and right lower face droops
Bell’s Palsy
Right CN VII lesion
Loss with stoke involving middle cerebral artery
Motor findings: precentral gyrus
Contralateral weakness of lower face
Contralateral spastic paralysis of upper body
Sensory findings: postcentral gyrus
Contralateral decreased sensation for face and upper body
If cognitive findings or visual loss are present the lesion is in cerebral cortex
Lacunar stroke involving motor axons of internal capsule
Affects motor neurons to face, upper/lower body on one side
Contralateral weakness of lower face
Contralateral spastic paralysis of upper and lower body
Webers syndrome
Damage to ventral midbrain
UM findings:
Contralateral weakness of lower face
Contralateral spastic paralysis of upper and lower body
LM findings:
Ipsilateral CN III weakness (Third nerve palsy-localizes lesion to the midbrain)
Damage to the ventral-medial medulla (caused by anterior spinal artery occlusion)
Medial Medullary “Dejerine” Syndrome
Motor findings:
Contralateral spastic paralysis of limbs (UMN loss- damage to pyramids, corticospinal tract)
Ipsilateral weakness of the tongue (LMN loss- damage to CN XII)- tongue points toward lesion
Sensory findings:
Contralateral loss of fine touch and conscious proprioception for the limbs (damage to the medial lemniscus)
Brown Seuqard Syndrome
Motor:
Spinal shock: initially flaccid paralysis, but spastic paralysis emerges over time
Spastic paralysis in Ipsilateral limb below level of lesion
Flaccid paralysis of Ipsilateral limb at level of lesion
Sensory:
Ipsilateral loss of fine touch and proprioception for the body and contralateral loss of pain and temperature for the body
Caused by trauma
Decorticate posturing
Lesion above red nucleus
Loss of corticospinal tract and disinhibition of rubrospinal tract