Localisation in Neurology

Question 1

Features of UMNL:

Answer 1

No wasting
No fasciculation
Increased tone
Increased reflexes
Plantars: up-going

Question 2

Features of LMNL:

Answer 2

Wasting
Fasciculation
Decreased tone
Decreased reflexes
Plantars: down-going

Question 3

When can you have wasting in an UMNL?

Answer 3

When the condition is chronic and wasting occurs due to disuse

Question 4

Brainstem lesion affecting CN III, IV and VI:

Answer 4

Diplopia

Question 5

Brainstem lesion affecting CN V:

Answer 5

Loss of facial sensation

Question 6

Brainstem lesion affecting CN VII:

Answer 6

Drooping

Question 7

Brainstem lesion affecting CN VIII:

Answer 7

Deaf and dizzy

Question 8

Brainstem lesion affecting CN IX, X and XII:

Answer 8

Dysarthria and dysphagia

Question 9

Brain stem lesion affecting CN XI:

Answer 9

Decreased strength in neck and shoulders

Question 10

Key feature of cerebellar lesion:

Answer 10

Incoordination

Question 11

Cerebellar lesions - DANISH:

Answer 11

Dysdiadochokinesia; dysmetria
Ataxia
Nystagmus
Intention tremor
Slurred speech (dysarthria)
Hypotonia (theoretical)

Question 12

Which side are the signs of a cerebellar lesion?

Answer 12

Ipsilateral

Question 13

What is ptosis?

Answer 13

Drooping of the upper eye lid

Question 14

Muscle myopathy:

Answer 14

Proximal weakness (motor only)

Question 15

NMJ:

Answer 15

Fatigable weakness (motor only)

Question 16

Peripheral nerve neuropathy:

Answer 16

Pain
Motor, sensory and reflex loss in specific root distribution
OR
Distal symmetric sensory loss and/or weakness

Question 17

Brachial or lumbosacral plexopathy:

Answer 17

Mixed nerve and root distribution

Question 18

Spinal nerve root radiculopathy:

Answer 18

Radicular pain

Motor, sensory and reflex loss in specific root distribution

Question 19

Anterior horn cell - LMN disease:

Answer 19

LMN weakness and reflex loss

Question 20

Dorsal root ganglion - sensory neuronopathy:

Answer 20

Sensory loss and reflex loss

Question 21

Spinal cord myelopathy:

Answer 21

LMN weakness at the level of the lesion
UMN below level of the lesion
Dissociated sensory loss
Neurogenic bladder

Question 22

Brain stem:

Answer 22

CN deficits
Impaired level of consciousness
Crossed/bilateral motor/sensory deficits

Question 23

Cerebellum:

Answer 23

Ataxia
Tremor
Nystagmus

Question 24

Thalamus:

Answer 24

Loss of consciousness or memory disturbance
Hemisensory loss and/or pain
Hemiataxia
Neglect or aphasia

Question 25

Basal ganglia:

Answer 25

Chorea (jerky shoulders, hips and face)
Athetosis (involuntary writhing movements - cerebral palsy)
Dystonia
Tremor
Rigidity

Question 26

Cerebral cortex encephalopathy:

Answer 26

Hemiplegia (UMN) and/or hemisensory loss
Aphasia
Neglect
Hemianopia
Dementia
Seizures