O slideshow foi denunciado.
Utilizamos seu perfil e dados de atividades no LinkedIn para personalizar e exibir anúncios mais relevantes. Altere suas preferências de anúncios quando desejar.
Próximos SlideShares
General principles of surgery - medical finals revision notes
Avançar
Transfira para ler offline e ver em ecrã inteiro.

4

Compartilhar

Baixar para ler offline

Summary of differentiating features of neurological deficits (motor)

Baixar para ler offline

Overview of different motor deficits for medical finals to aid clinical reasoning.

Audiolivros relacionados

Gratuito durante 30 dias do Scribd

Ver tudo

Summary of differentiating features of neurological deficits (motor)

  1. 1. Tone Reflexes Plantars Muscles Distribution Other Increased (clasp knife spasticity) Increased Up * Contralateral to lesion * According to territory * Clonus Decreased Decreased Down Wasting * Ipsilateral * Myotome or named nerve distribution * Fasciculations Increased (rigidity, cogwheeling if + tremor) * Bradykinesia or hyperkinesia * +/- Tremor * Cranial nerve lesion on ipsilateral side * Hemiplegia on contralateral side * Ataxia * Nystagmus * INOP * Vertigo * Dysarthria Decreased Decreased wasted (e.g. tongue) * Cranial nerves IX-XII in the medulla * Hoarse voice MND, GBS, Polio, MG, syringobulbia, brainstem tumours, central pontine myelinolysis Increased Increased, including palatal reflexes * UMN lesion of muscles of swallowing and talking due to bilateral lesions above the mid pons. * slow tongue movements * slow deliberate speech * pseudobulbar affect: unprovoked weeping or giggling "emotional incontinence" MS, MND, stroke, central pontine myelinolysis Hypotonia Hyporeflexia * Eyes * Arms * Legs * Trunk * Ipsilateral or bilateral * Dysdiadochokinesia * Ataxia * Nystagmus * Intention tremor, Dysmetria * Staccato/slurred speech Tone reduced in acute cord compression Hyperreflexia below level of lesion, hyporeflexia at level of lesion, normal above level of lesion. In acute lesion reflexes decreased. * Motor and sensory symptoms with sensory level, LMN lesion at level and UMN lesion below level Myasthenia gravis Normal * Extraocular * Bulbar * Face * Neck * Limb * Trunk * FATIGUABILITY also: botulinum toxin! Lambert Eaton myasthenic syndrome Hyporeflexia * Gait before eyes * Autononic (dry mouth) * Movements improve symptoms Muscular dystrophy Preserved Duchenne's: pseudohypetrop hy of calves * Symmetrical PROXIMAL weakness: can't get out of chair or comb hair * Across distributions * +/- Respiratory / cardiac symptoms * Gower's sign * Gradual onset * Oddly firm muscles Duchenne vs Becker's vs drug vs inflammatory inclusion body myositis Myotonic dystrophy Wasting * DISTAL weakness * Facial weakness * +/- Respiratory / cardiac * Myotonia (prolongued muscle contractions) Metabolic/ischaemic myopathy * Pain after / on exercise What could mimic weakness: reduced proprioception, pain, reduced sensation in hands (e.g. carpal tunnel syndrome) Differentiating Features of Weakness Type of Lesion Properties UMN LMN Extrapyramidal Brainstem Bulbar Pseudobulbar Cerebellar Cord Lesion NMJ lesion Myopathy
  2. 2. * Symmetrical PROXIMAL * +/- Dysphagia * +/- Dysphonia * +/- Respiratory weakness * Striated muscle only * Progressive * + Myalgia (spontaneous pain at rest) * Can be paraneoplastic: skin rashes, fever, arthralgia, Raynaud's * +/- Evidence of systemic disease, or pulmonary fibrosis, myocarditis, fever, Raynaud's * DERMATOMYOSITIS = myositis + skin signs, e.g. heliotrope, macular rash, Gottron's papules, ... Areflexia * DISTAL weakness (or ascending as in GBS) * + Paraesthesiae * + Autonomic * Rapid onset * +/- pain (inflammation) Myositis = inflammatory myopathy Neuropathy Multifocal motor neuropathy with conduction block Named nerve palsy
  • MorganParrott1

    Sep. 25, 2020
  • laurentgraham

    Oct. 2, 2018
  • RaviRolan

    Jun. 11, 2018
  • BonnieEnoshAmof

    Apr. 18, 2016

Overview of different motor deficits for medical finals to aid clinical reasoning.

Vistos

Vistos totais

1.110

No Slideshare

0

De incorporações

0

Número de incorporações

5

Ações

Baixados

112

Compartilhados

0

Comentários

0

Curtir

4

×