Findings Helpful for Localizations Within the Nervous System
Signs | |
---|---|
Cerebrum | Abnormal mental status or cognitive impairment |
Seizures | |
Unilateral weaknessa and sensory abnormalities including head and limbs | |
Visual field abnormalities | |
Movement abnormalities (e.g., diffuse incoordination, tremor, chorea) | |
Brainstem | Isolated cranial nerve abnormalities (single or multiple) |
Crossed weaknessa and sensory abnormalities of head and limbs, e.g., weakness of right face and left arm and leg | |
Spinal cord | Back pain or tenderness |
Weaknessa and sensory abnormalities sparing the head | |
Mixed upper and lower motor neuron findings | |
Sensory level | |
Sphincter dysfunction | |
Spinal roots | Radiating limb pain |
Weaknessb or sensory abnormalities following root distribution (see Figs. 180-1 and 180-2) | |
Loss of reflexes | |
Peripheral nerve | Mid or distal limb pain |
Weaknessb or sensory abnormalities following nerve distribution (see Figs. 180-1 and 180-2) | |
Stocking or glove distribution of sensory loss | |
Loss of reflexes | |
Neuromuscular junction | Bilateral weakness including face (ptosis, diplopia, dysphagia) and proximal limbs |
Increasing weakness with exertion | |
Sparing of sensation | |
Muscle | Bilateral proximal or distal weakness |
Sparing of sensation |
aWeakness along with other abnormalities having an upper motor neuron pattern, i.e., spasticity, weakness of extensors > flexors in the upper extremity and flexors > extensors in the lower extremity, and hyperreflexia.
bWeakness along with other abnormalities having a lower motor neuron pattern, i.e., flaccidity and hyporeflexia.