Patterns of Neurological Presentations

Question 1

describe the weakness seen with an UMN lesion

Answer 1

corticospinal distribution i.e. hemiparesis, quadriparesis

Question 2

describe the weakness seen with an LMN lesion

Answer 2

generalised

predominantly proximal, distal or focal

Question 3

describe the sensory loss seen with an UMN lesion

Answer 3

central pattern

Question 4

describe the sensory loss seen with an LMN lesion

Answer 4

can have none or a glove/stocking/peripheral distribution

Question 5

describe the effect an UMN lesion has on deep tendon reflexes

Answer 5

increased

Question 6

describe the effect an LMN lesion has on deep tendon reflexes

Answer 6

normal or decreased

Question 7

describe the effect an UMN lesion has on superficial reflexes

Answer 7

decreased

Question 8

describe the effect an LMN lesion has on superficial reflexes

Answer 8

normal

Question 9

describe the effect an UMN lesion has on pathological reflexes

Answer 9

increased

Question 10

describe the effect an LMN lesion has on pathological reflexes

Answer 10

normal

Question 11

describe the effect an UMN lesion has on muscle tone and bulk

Answer 11

tone increased

bulk = sometimes hypertrophy

Question 12

describe the effect an LMN lesion has on muscle tone and bulk

Answer 12

tone = normal/decreased
bulk. = wasting

Question 13

what type of lesion is suggested by a stocking + glove pattern of sensory loss?

Answer 13

length dependent neuropathy

Question 14

what type of lesion is suggested by a dermatomal pattern of sensory loss?

Answer 14

mononeuropathy

radicular or plexus lesion

Question 15

what type of lesion is suggested by a sensory level pattern of sensory loss?

Answer 15

spinal cord lesion

Question 16

what type of lesion is suggested by hemianesthesia?

Answer 16

contralateral cerebral lesion

Question 17

what type of lesion is suggested by dissociated sensory loss with lost spinothalamic sensation but preserved dorsal column?

Answer 17

hemi cord damage

Question 18

describe a cerebellar gait

Answer 18

broad based

unsteady

Question 19

how is intention tremor/ataxia assessed?

Answer 19

arms = finger nose test 
legs = knee heel test 

tremor exaggerated nearer to the target

Question 20

what is dysdiadochokinesis?

Answer 20

clumsy, fast alternating movements

Question 21

what are some possible features of cerebellar disorders?

Answer 21

intention tremor
dysdiadocochokinesis
nystagmus
dysarthria

Question 22

what are some possible signs associated with frontal lobe dysfunction?

Answer 22

personality dysfunction
seizures
incontinence
visual field defects
anosmia

Question 23

what are some possible signs associated with temporal lobe dysfunction?

Answer 23

memory dysfunction
agnosia
visual field defects
temporal lobe epilepsy
auditory dysfunction

Question 24

what are some possible signs associated with parietal lobe dysfunction?

Answer 24

visual field defect
sensory dysfunction
gerstmann's syndrome
dyspraxia
denial

Question 25

what is gerstmann’s syndrome?

Answer 25

dysgraphia
left-right disorientation
finger agnosia
acalculia