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LOCALIZATION OF CNS LESIONS

May 15, 2010 by hdurina84

LOCALISATION OF CNS LESIONS

      1)MUSCLE : No sensory loss

.if myopathy …there is more proximal muscle weakness than distal.

if myositis……there is rash /alopecia /joint pains

 

2)NMJ   : myasthenia : weakness progresses with exercise

                 eaton lambert : weakness disappears with exercise

 

       3)NERVE :

Peripheral nerve: Mononeuropathy or Polyneuropathy (glove and stocking) Pattern of motor/sensory loss is patchy/ asymmetric and discontinuous

( not in the form of a band characteristic of a dermatome)

 

nerve root (radiculopathy) dermatomal distribution  (continuous)

h/o back pain

 3)SPINAL CORD:

 

motor/sensory dysfn below level of lesion/ bowel n bladder dysfn

 

unilat: ipsilat motor and post column( as they cross at brain stem level)

contralat tem n pain loss ( as the fibres cross immediately after they enter the spinal cord)

 

4)CEREBELLUM:

 

  • Lateral: Ipsilateral UE dysmetria, dysdiadochokinesia, ataxia, intention tremor, dysarthria with "scanning" speech. 
  • Central (metabolic, ETOH): Truncal & LE ataxia, disturbance of equilibrium, wide based gait, nystagmus, dysmetria on heel-to-shin.

 


5)BRAIN STEM: (crossed hemiplegia) 

Motor /sensory / pain/ propriception  deficits on opposite side of lesion(hemiplegia /hemosensory loss)  as all tracts cross in brainstem.

Cranial nerve signs on the same side of lesions.



6) BASAL GANGLIA:

Meaningless / unintentional /unexpected movements.(chorea/hemiballismus/athetosis)

 

     


    7) INTERNAL CAPSULE :

          Sensory /motor deficits contralateral to lesion. (hemi paresis and hemisensory both)



    8) CORTEX :

       deficits in conciousness.

          sensory/motor deficits  plus higher level deficits like aphasia/ agraphia/agnosia/apraxia.

          Anterior circulation :  Leg involvement contralateral.

          Middle circulation :    Arm and face involvement contralateral side.  

 

 

Case Discussion: 

THE DD OF CNS LESIONS.

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