Lesions of upper motor neurons

These may occur as a consequence of disorders of brain or spinal cord. Upper motor neuron weakness of the arms begins distally and spreads proximally. Flexor muscles are usually relatively spared, and therefore the arm assumes a flexor posture. The flexor muscles of the leg are affected to a greater extent than the extensors, and proximal muscles are affected early. Thus the leg assumes an extensor posture. Eventually both limbs develop 'clasp knife' rigidity and clonus may be demonstrated. Reflexes are brisk and the plantar response is typically extensor. Wasting of the muscles is not usually a prominent early feature.

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