Sensory Impairment

LESION LOCALISATION (contd)

Sensory deficit

FACIAL SENSORY LOSS

HEMI SENSORY LOSS

HEMI SENSORY LOSS

Useful localising features (if present)

Loss of all modalities in the limbs (depending on the extent of the lesion). Loss of pain and temperature on the opposite side of the face with or without 'muzzle' area sparing and a lateral gaze palsy towards that side.

As above - but lateral gaze normal.

Weakness of palate and tongue on side opposite to the limb sensory deficit.

Loss of pain, temperature and light touch below a specific dermatome level (may spare sacral sensation).

Loss of all modalities at one or several dermatome levels.

Loss of pain and temperature below a specific dermatome level.

Loss of proprioception and 'discriminatory' touch up to similar level and limb weakness.

Lesion site

CONTRALATERAL PONTINE LESION

(Ipsilateral to the facial sensory loss)

CONTRALATERAL

MEDULLARY

LESION

CONTRALATERAL SPINOTHALAMIC TRACT LESION

lesion)

BROWN-SEQUARD SYNDROME

CONTRALATERAL

MEDULLARY

LESION

CONTRALATERAL SPINOTHALAMIC TRACT LESION

lesion)

BROWN-SEQUARD SYNDROME

(Partial cord lesion)

(Partial cord lesion)

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