Limb weakness

Question 1

What does -plegia vs -paresis mean

Answer 1

• plegia=total paralysis

- paresis=weakness

Question 2

What does hemi- vs para- vs tetra- mean

Answer 2

Half the body,
Lower limbs,
All 4 limbs

Question 3

Site of lesion of full body hemiparesis on one side

Answer 3

Contralateral cerebral cortex (widespread stroke)

Contralateral corona radiata, internal capsule or pons (stroke)

Question 4

Site of lesion of limb hemiparesis on one side

Answer 4

Contralateral cerebral cortex (stroke)

Contralatera corona radiata, internal capsule or pons (stroke)

Ipsilateral spinal lateral motor tract (cervical disk prolapse)

Question 5

Isolated limb weakness

Answer 5

Contralateral cerebral motor cortex (e.g. localized stroke)

Contralateral corona radiata, internal capsule, or pons (e.g. stroke)

Ipsilateral peripheral nerve root (e.g. osteophyte)

Ipsilateral peripheral nerve plexus (e.g. trauma to brachial plexus)

Ipsilateral peripheral nerve per se (e.g. angiogram sheath injury to the femoral nerve)

Question 6

Paraparesis causes

Answer 6

Bilateral cerebral motor cortx (parasagittal meningioma)

Bilateral motor spinal tracts (cord compression)

Cauda equina (lumbar intervertebral disc prolapse)

Bilateral lumbosacral plexus (GBS)

Question 7

Tetraplegia causes

Answer 7

Bilateral motor tracts of cervical spinal cord (e.g. traumatic spinal cord transection at C5) Peripheral nerves (demyelinating disease, i.e. Guillain–Barré syndrome)

Question 8

Proximal muscle weakness

Answer 8

Neuromuscular junction (e.g. myasthenia gravis, Eaton–Lambert syndrome)

Muscle (e.g. polymyositis, dermatomyositis) or

secondary to other conditions (e.g. hyperparathyroidism) or drugs (e.g. statins)

Question 9

Several episodes separated in time and space

Answer 9

Various sites in central nervous system (e.g. multiple sclerosis)

Question 10

Eyes deviate towards weak side vs away from weak side

Answer 10

If the eyes deviate away from the weak side, this suggests a c ortical lesion. If the eyes deviate towards the weak side, this suggests a brainstem lesion.

Question 11

LMN signs and sensory problems, where must the issue be

Answer 11

A nerve root or peripheral nerve lesion (sensory signs present)

with neuromuscular or muscular lesion they are absent