Localisation In Neurology

Question 1

Aetiology of lesion

Answer 1

Acute(minutes to hours) = vascular, epileptic seizure, trauma

Subacute: days to weeks = inflammation,infection or haemorrhage

Chronic progressive: months to years = degenerative like Alzheimer’s or Parkinson’s

Question 2

Lower motor neurone weakness

Answer 2

Wasting
Fasciculation

Decreased tone

Decreased reflexes

Down going plantars

Question 3

Upper motor neuron weakness

Answer 3

No wasting
No fasciculation

Increased tone

Increased reflexes

Up going plantars

Question 4

Features of a cortical lesion

Answer 4

Aphasia,apraxia,agnosia

Visual field defects

Deficit in memory and executive functions
Loss of olfaction

Motor: hemi-paresis

Sensory: hemi sensory loss

Brisk reflexes

Extensor plantar

Question 5

Brain stem lesions ?

Answer 5

Hifgher corical function normal

Cranial nerves:

3,4,6: Diplopia
5: decreased facial sensation 
7:drooping 
8: deaf and dizzy
9,10,12: dysarthria and dysphasia 
11: decreased strength in neck and shoulders

Question 6

Celerbellar lesions acronym

Answer 6

(Uncoordiantion)

DANISH

Dysmetria

Ataxia

Nystagmus

Intention tremor

Slurred speech

Hypotonia

Question 7

Ataxia! Lesion is unilateral then symptoms are

Answer 7

Ipsilateral

Causes: stroke,tumour or demyelination

Question 8

Causes of bilateral ataxia

Answer 8

Stroke, tumour demyelination

Toxic (alcohol, drugs)

Metabolic (B12 and E deficiency)

Paraneoplastic(small cell lung, breast, ovarian and lymphoma)

Post infections

Question 9

Spinal cord lesion effects

Answer 9

Sensory level

Weakness below lesion

upper motor neurone signs below the lesion

Bowel and bladder incontinence (sphincter problems)

Question 10

Spastic paraparesis is

Answer 10

Bilateral UMN signs below the lesion

Localise by working up (include jaw jerk)

Question 11

Look for what in spastic paraparesis

Answer 11

Cranial nerves for evidenced MS or MND

Question 12

Anterior cord syndromes effects

Answer 12

Injury or stroke or infectionresults in

Loss of ascending pain/temp below injury

Preserved proprioception and vibration

Reflexes brisk

Tone goes up

Plantars go up

Typical anterior spinal artery infarction

Question 13

Anterior cord syndrome aetiology

Answer 13

Anterior spinal infarction

Cord stroke 
Post traumatic (whiplash/chiropractor)

Question 14

Posterior cord syndromes

Effects

Answer 14

Loss of vibration and proprioception

Everything else preserved

Question 15

Posterior cord syndromes classic aetiologies

Answer 15

Low b12 
Syphilis 
HIV myelopathy 
Demyelination got dz
Heavily myelinated pathways

Question 16

Brown sequard syndrome features

Answer 16

Impact on left side (e,g)
Pain and temp loss on contralateral side (right)

Proprioception loss on ipsilateral side (left)

Weakness on ipsilateral side (left)

Question 17

Central cord syndromes cause

Answer 17

Loss of bilateral crossing pain and temp fibres

Loss of bilateral motor

Main cause is expansion of the canal

Question 18

Root lesion (motor) features

Answer 18

Asymmetric weakness

Question 19

Root lesion (sensory) 
Features

Answer 19

Abnormal sensation in dermatomal distribution

Question 20

Root lesion (reflex)

Features

Answer 20

Reflexes become hypo

Question 21

Hallmark of a neuromuscular junction problem

Answer 21

Fatiguability

Question 22

Other features of neuromuscular junction problems

Answer 22

Weakness - proximal and symmetric

Exacerbated by use recovered with rest

Affects facial muscles often

Sensation: normal

Question 23

Muscle disorders : cranial nerves , motor and sensory

Answer 23

Pros is, dysconjugate game, dysphasia, dysphonia

Motor: proximal weakness in UE +LE, atrophy and fasciculation s, hypotonia

Sensory: normal

Reflexes preserved until late in disease