Neurology - Symptoms

Question 1

What are the signs of an UMN lesion?

Answer 1

Muscle weakness. A pattern of weakness in the extensors (upper limbs) or flexors (lower limbs), is known as ‘pyramidal weakness’

Decreased control of active movement, particularly slowness

Spasticity

Clasp-knife response where initial higher resistance to movement is followed by a lesser resistance

Babinski sign is present

Increased deep tendon reflex (DTR)

Pronator drift

Question 2

What are signs of a LMN lesion?

Answer 2

Muscle paresis or paralysis

Fibrillations

Fasciculations – caused by increased receptor concentration on muscles to compensate for lack of innervation.

Hypotonia or atonia – Tone is not velocity dependent.

Hyporeflexia

Strength – weakness is limited to segmental or focal pattern, Root innervated pattern

Question 3

What can give UMN signs?

Answer 3

stroke, multiple sclerosis, traumatic brain injury and cerebral palsy

Question 4

What can give LMN signs?

Answer 4

Guillain–Barré syndrome, C. botulism, polio, cauda equina syndrome, Myasthenia gravis, Amyotrophic lateral sclerosis (ALS, MND)

Question 5

Signs of a cerebellar disorder

Answer 5

Dysmetria
Finger-to-nose test
Ankle-over-tibia test
Dysdiadochokinesis
Rapid pronation-supination
Ataxia
Assessment of gait
Nystagmus
Intention tremor
Staccato speech