Aug 25, upper motor neuron lesion

Comparison of upper motor neuron lesion and lower motor neuron lesion syndromes:

Location of the lesion, Structurescentral nervous system cortex, brain stem, corticospinal tracts, CordCranial spinal nerves cores/nerves and spinal cord: anterior horn cell cell, spinal roots, peripheral nerves

Stroke, traumatic brain injury, spinal cord in jury polio, Guillain-Barre, peripheral nerve injury, peripheral neuropathy, Radiculopathy

Increased: Hypertension, velocity DependentDecreased or does not exist: hypotension, flaccid, not speed dependent

Hyperreflexia increased:, Clonus, excessive cutaneous and Autonomic reflexes, + BabinskiDecreased or does not exist: Hyporeflexia, cutaneous reflexes reduced or not available

Muscle of spasms: flexor or ExtensorWith denervation: Fasciculations

Weakness or paralysis: ipsilateral(stroke) or bilateral(SCI) Corticospinal: contralateral when on Decussation Medulla in; ipsilateral if see distribution: never FocalIpsilateral weakness or paralysis; Limited distribution: focal or segmental pattern, root innervated pattern

Non-use of atrophy: variables, widespread distribution, especially of Antigravity MusclesNeurogenic atrophy: rapid, focal distribution, harder to waste

Impaired or absent: Dyssenergic pattern, compulsory mass SynergiesWeak or does not exist, if nerves interrupted

Spinal cord:

It is a continuation of the medulla and channel runs within the spine extends itself from the foramen Magnum CONUS Medullaris (cone shaped) that roughly on the level which is the second vertebra.

Below the level of the second vertebra, is a collection of nerve similar to a horse’s tail the descents of spinal cord and is known as the Cauda Equina. This nerve from L2 S5 consists of. The length of the spinal cord is approximately 17 inches.

The passage for spinal spine is the spine of foramen surrounded and the bony structures of each individual vertebrae. The opening through which the spinal nerve end roots, the spinal canal is known as INTERVERTEBRAL FORAMEN. It is the superior vertebral notch of the vertebra below and the inferior vertebral notch of above vertebrae. This foramen is located on the side of the spine.

The cross sectional view of the spinal cord shows white substance on the periphery and grey matter in their centre. The grey matter in the middle of the spinal cord is shaped H-shaped or butterfly. The upper part of the rear Horn is the h and the lower part is the anterior horn cell. Motor impulses from the brain down the spinal cord through the anterior horn cell travel and out on the periphery of spinal nerves. During the sensory impulses from the periphery to the nerves travel, enter the spinal cord by the back Horn and then the string rises to the level of the brain.

The white matter of the spinal cord routes include ascending and descending (motor) fibre. All these pathways lead to certain types of pulse. The way that is of particular importance for the mušle control is is that CORTICOSPINAL tract. It runs from the engine of the cerebral cortex to the spinal cord and crossed at the bottom of the brain stem.

Engine are called neurons, that above this level synapse as top MOTORNEURONE and those who at or below the level of the anterior horn cell cells are called synapse lower MOTORNEURONE. If a violation/lesion between brain and the spinal cord i.e. proximal anterior horn cell, it is called or as a upper CYCLESMOTO NEURON LÄSIONconsidered. If injury or lesion between the anterior horn cells of the spinal cord and the peripheral part occurs, it as a lower MOTOR NEURON LÄSIONwill be considered.

Examples of upper motor neuron disease are cross-cutting disease, multiple sclerosis, Parkinson’s disease, CVA, etc.. Examples of lower motor neuron disease are polio, muscular dystrophy, myasthenia gravis and peripheral nerve injuries. In both cases the lower motor neuron or upper motor neuron lesion paralysis leads in the rule, but the clinical symptoms vary.

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