UMN Lesions Flashcards
where do UMN lesions occur vs LMN lesions?
Spinal cord to head lesion= UMN
Spinal cord to muscles= LMN
Compare the symptoms of UMN vs LMN conditions
PSFsCPbEM vs FpHHAbFFM
Compare the conditions which cause UMN vs LMN
name all LMN conditions + 2 conditions which cause both UMN + LMN
8 Positive VS. 3 negative features of UMN syndrome?
6 consequences of spasticity?
Restricts normal movement
Results in Excessive/inappropriate movement
Pain
Interferes with function: active or passive
Tissue damage + Soft tissue/joint changes
3 types of spasticity + management for each?
name 5 different drugs for spasticity + describe their MOAs?
Baclofen vs Diazepam/Clonezepam vs Gabapentin/Pregabalin
Tizanidine vs Dantrolene?
One of the ways to treat spasticity is by intrathecal baclofen or oral baclofen. How does intrathecal baclofen work?
2 things which have to be done over time
A Baclofen Pump catheter is threaded into intrathecal space of T5
This treats Tone, Spasticity + Hyporeflexia in the Lower limb, but bc of its location it cannot treat these symptoms in the Upper limb :(
There is Long term follow up for refills + Pump replacement!
Compare oral vs intrathecal baclofen
what do patients who can’t tolerate baclofen get instead?
Compared to oral doses of baclofen:
Much lower doses of intrathecal baclofen required to relieve non-focal spasticity - despite this a Relatively high conc in CSF still achieved! (50x higher) + there is only a small systemic effect :)
Doesn’t affect upper parts of brain or body -> fewer side effects
Seriously ill patients who cannot tolerate baclofen will instead get intrathecal Phenol
What is the positioning for intrathecal phenol?
Note - can be repeated in opposite side the next day!
Describe some features of UMN syndrome
Muscle weakness of one side of the face + Dribbling on weaker side
Hyperreflexia on the weaker side
Knee extensors are strong - but knee flexors are weak!
Negative signs = higher-level neural dysfunction or frank absence of Voluntary movement!
