Zespoły Flashcards
Upper motor neuron lesion
- Muscle weakness (pyramidal weakness)/ paresis
- Spasticity, increased muscle tone -> Clasp-knife response where initial higher resistance to movement is followed by a lesser resistance
- Increased deep tendon reflexes
- Decreased or absence of superficial reflexes
- Pathological reflexes: Babinski sign, pronator drift
Lower motor neuron lesion
- Muscle paresis or paralysis
- Hypotonia or atonia – Tone is not velocity dependent
- Hyporeflexia (decreased or absence of both deep reflexes and cutaneous reflexes)
- Muscle atrophy
- Fibrillations or fasciculations (caused by increased receptor concentration on muscles to compensate for lack of innervation)
Extrapyramidal symptoms
- Altered quantity and velocity of movement (bradykinesia/ hyperkinesia)
- Altered muscle tone (hypotonia/ hypertonia)
- Involuntary movement (tremors, chorea, dystonia, ballismus)
- Akathisia - a feeling of internal motor restlessness that can present as tension, nervousness, or anxiety
- Altered posture reflexes
Cerebellar symptoms symptoms
- Ataxia
- Intention tremor
- Dysmetria (undershoot or overshoot of intended position with the hand, arm, leg, or eye)
- Dysdiadochokinesia (impaired ability to perform rapid, alternating movements)
- Dysarthria - speech disorder (motor, scanning speech)
- Nystagmus (involuntary movement of the eye)
- Ataxic Gait -> wide-based gait
- Muscle hypotonia
Bulbar palsy symptoms symptoms
- dysarthria
- dysphagia (difficulty in swallowing)
- difficulty in chewing
- absent or decreased jaw jerk
- palate paralysis + absent/ decreased gag reflex
- atrophic tongue or its fasciculations or tongue paresis
Pseudobulbar palsy symptoms symptoms
- dysarthria
- dysphagia (difficulty in swallowing)
- difficulty in chewing
- brisk jaw jerk
- Positive primitive (atavistic) reflexes = frontal release signs (ex. snout reflex = Pout)
- Small, stiff and spastic tongue
- Labile affect -> involuntary laugh or cry
Frontal lobe lesion symptoms
- Contralateral muscle weakness/ paralysis
- Eyes look toward brain lesion
- Motor aphasia
- Frontal release (primitive) signs
- Dyspraxia/ Apraxia
- Loss of urinary sphincter control
- Behaviour symptoms
- Epileptic attack -> simple partial motor, adversive (sudden, long look of both eyes in one direction)
Behaviour symptoms of frontal lobe lesion symptoms
- Disinhibition (lack of restraint, criticism)
- Deficits in concentration and orientation
- Impaired judgement
- Impaired ablitity to plan, abstract thinking
- Moria, overcheerfulness
Nondominant parietal cortex lesion symptoms
- Impaired contralateral sensation
- Cortical sensory defects: contralateral agnosia, astereognosia, agraphesthesia, defects in two point discrimination
- Loss of lower quadrant of vision -> opposite to the lesion in both eyes
- Contralateral hemineglect
- Epileptic attack -> simple partial sensory
Dominant parietal cortex lesion symptoms
- Symptoms of nondominant parietal cortex lesion +
- Agraphia
- Acalculia
- Finger (touching) agnosia
- Left-right disorientation
- Amnestic Aphasia
Temporal cortex lesion symptoms
- Short memory amnesia
- Loss of upper quadrant of vision -> opposite to the lesion in both eyes
- Receptive (Wernicke) aphasia (only in dominating hemisphere)
- Depression
- Extensive irritability
- sexual disinhibition
- Epileptic attack -> complex partial
Occipital cortex lesion symptoms
- Contralateral (visual field) hemianopsia (with intact macular fields)
- Inability to follow finger with eyes
- Visual agnosia, Color agnosia
- Alexia
- Epileptic attack -> simple visual
Demetia general symptoms
- Amnesia and learning difficulties
- Impaired judgement, abstract thinking
- Impaired understanding, space orientation
- Other cortical defects: aphasia, apraxia, agnosia, acalculia, dysgraphia
- Behavioural changes: agression, arousal, depression
Parkinsonism symptoms
Bradykinesia + 1 out of 2:
1. Rest tremor
2. Rigidity
+ postural instability
Brainstem lesion symptoms
Ipsilateral
- Sensory deficits (face, V nerve)
- Horner syndrome
- IX and X nerve palsy
Contralateral
- Motor and Sensory deficits from spinal nerves
- Nystagmus
+ hiccup
+ Vertigo
Horner syndrome symptoms
Ptosis - drooping of the upper eyelid Anhidrosis - decreased sweating Miosis - constriction of the pupil Enophthalmos - posterior displacement of the eyebal Loss of ciliospinal reflex
+ Heterochromia iridum -> in congenital Horner syndrome -> difference in coloration of the iris