Limb Weakness

LOWER MOTOR NEURON WEAKNESS

✓ Anterior horn cell

Muscle

✓ Anterior horn cell

Muscle

MUSCLE TONE

Hypotonicity with diminished resistance to passive stretch. Clonus - absent.

MUSCLE FASCICULATION

Present - irregular, non-rhythmical contractions of groups of motor units. More prevalent in anterior horn cell disease than in nerve root damage.

MUSCLE WASTING

Wasting becomes evident in the paretic muscle within 2-3 weeks of the onset.

REFLEXES

- Tendon - depressed or absent.

- Superficial - rarely affected (abdominal, cremasteric).

- Plantar response - flexor.

DISTRIBUTION

Either - muscle groups involved in distribution of a spinal segment/root, plexus or peripheral nerve, or - generalised limb involvement affecting proximal or distal muscles or following a specific distribution, e.g. facioscapulohumeral dystrophy.

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