Limb Weakness

UPPER MOTOR

NEURON LIMB WEAKNESS - BILATERAL

Face (lower , motor neuron)

Useful localising features (not always present)

Facial movements lost but vertical eye movements retained 'locked-in syndrome'.

Lesion site

BILATERAL PONTINE LESION

TETRAPLEGIA

PARESIS) yo Face spared am Both (( ) arms

Both legs '

Diaphragmatic respiration.

PARAPLEGIA

PARAPLEGIA

CRUCIATE HEMIPLEGIA

Facial movements retained, but no tongue or palate movement or speech - a variant of the 'locked-in' syndrome.

Ventilatory support required (no cranial nerve lesion).

Diaphragmatic respiration.

Discriminatory sensory loss. 'Frontal' incontinence. (Pain and temperature sensation intact.)

'Sensory level' - impairment or loss of all sensory modalities. Hesitancy of micturition or acute urinary retention.

Weakness of the palate and tongue on the side of the arm weakness.

CRUCIATE HEMIPLEGIA

BILATERAL

MEDULLARY

LESION

BILATERAL CERVICAL SPINE LESION

BILATERAL THORACIC

SPINE LESION

'arm' fibres

MEDULLARY LESION (below 'arm' fibre decussation above 'leg' fibre decussation)

'arm' fibres

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