Anatomical Localization in Neurological Diagnosis
| Anatomical structure | Associated clinical features |
|---|---|
| Meninges | Headache, neck stiffness, photophobia |
| Cerebrum | |
| Seizure, dysphasia, hemianopia, neglect, apraxia, dyscalculia, other disturbances of higher cortical function | |
| Bradyphrenia, executive dysfunction, personality change |
| Pyramidal distribution weakness, hyper-reflexia, spasticity, extensor plantar |
| Tremor, rigidity, bradykinesia, hemiballismus, chorea |
| Reduced conscious level, impaired attention |
| Cerebellum | Nystagmus, dysarthria, dysmetria, ataxia, dysdiadokokinesis |
| Brainstem | ‘Crossed’ (e.g. ipislateral facial and contralateral limb weakness with a pontine lesion), other cranial nerve deficits +/- long tract signs, ‘locked-in’, quadriparesis |
| Spinal cord | Paraparesis or quadriparesis, sensory level (may be suspended, crossed and/or dissociated), extensor plantars, sphincter and autonomic dysfunction |
| Motor neurons/anterior horn | Mixed upper and lower motor neuron signs, fasciculations |
| Nerve roots | Radicular pain (deep within limb or radiating ‘electric shock’), weakness in a group of muscles, localized areflexia |
| Dorsal root ganglia | Ataxia, pseudoathetosis, areflexia |
| Plexus | Pain then weakness > sensory disturbance, involves multiple root and nerve territories |
| Peripheral nerve | |
| Characteristic pattern of selective muscle weakness and sensory loss in a single limb |
| Weakness proportional to wasting (distal > proximal), glove and stocking sensory loss | |
| Proximal and distal weakness out of proportion to wasting, global areflexia |
| Pain, selective loss of pin-prick and temperature sensation, autonomic dysfunction, preserved power and reflexes |
| Neuromuscular junction | Fatigable diplopia, ptosis, dysarthria, facial and proximal limb weakness, no sensory loss |
| Muscle | Characteristic distribution of weakness (often proximal), wasting, myalgia, no sensory loss |