Neurology of the Upper and Lower motor neurone diseases

Question 1

what do the alpha motor neurones do ?

Answer 1

• voluntary muscle contraction

Question 2

What do the gamma motor neurones do ?

Answer 2

regulate muscle tone , maintain proprioception

Question 3

what counts as an upper motor neurone lesion?

Answer 3

1) Damage above the medulla = Hemiplagia ( weakness in half the body)
2) damage bellow the medulla :
- spinal chord syndrome

Question 4

signs of an upper motor neurone lesion ?

5

Answer 4

1) Muscle weakness
2) Hyperreflexia
3) spasticity ( tight muscles, muscles become rigid )
4) clonus = rhythmic contractions
5) Positive babinski response ( big toe is pulled back )

Question 5

Signs of a lower motor neurone lesion

Answer 5

1) Flaccidity
2)Hyporeflexia
3)Fasciculations
4)Muscle wasting /atrophy
damage to the peripheral nervous system

Question 6

what does the basal ganglia do ?

2

Answer 6

1) extrapyramidal system (involuntary actions)
- sequencing and smooth muscle control
- fluidity to movement

Question 7

what can happen hypokinesis ?

Answer 7

Hypokinesia is caused by basal ganglia damage and, in Parkinson disease, with loss of the dopaminergic cells in the substantia nigra pars compacta.

• muscle movement is slow
• stiff muscles
• resting tremor

Question 8

what can happen in Hyperkinesis ?

Answer 8

too much movement

• tremor
• chorea ( jagged movements)
• ballism ( big movements of the limbs)
• Myoclonus (quick involuntary muscle jerks like hiccups)
• Dystonia (repetitive , twisting movements )

Question 9

what does the cerebellum control

3

Answer 9

The cerebellum is located in the back of your brain. It helps with the coordination and movement related to motor skills, especially involving the hands and feet. It also helps maintain posture, balance, and equilibrium

Question 10

what can happen in cerebellar dysfunction ?

Answer 10

1) Nyastagmus (involuntary movements of the eye)
2) intention tremor, and missing the target
3) Wide , unsteady gait
4) dysarthria = speech difficulty
5) cerebellar representations ie : left cerebellar lesion = left sided ataxia = lack of coordination on left side of body)

Question 11

what happens in spastic Quadraplegia ?

4

Answer 11

• lesion above C5
• palsy that affects all 4 limbs
• paralysis occurs below the lesion
• loss of sensory modalities below lesion
• loss of bowel , bladder and sexual function

Question 12

What is spastic Paraparesis ?

Answer 12

lesion below T1 ( ONLY LEGS)
-incomplete
Bilateral leg weakness and not complete muscle paralysis
- impaired sensory function
- defective bowel , bladder, and sexual function

Question 13

what conditions can give upper motor neurone Signs ?

Answer 13

1) Brain tumour
2) Ischaemic stroke
3) Intercranial haemorrhage
4) post head injury trauma
5) MS
6) prolapsed disc

Question 14

what two signs can occur in LMN lesion ?

Answer 14

damage to the peripheral nervous system:

• Foot drop
• Wrist Drop