Localising a lesion

Question 1

What makes up the central nervous system?

What makes up the peripheral nervous system?

Answer 1

Brain and spine

Spinal nerves to muscles

Question 2

CNS:

What would be the presentation of pathology in the cortex? Examples?

What would be the presentation of pathology in the basal ganglia? Examples?

Answer 2

Behaviour
Cognition/memory
Language - STROKE
Seizures - EPILEPSY

Increased/decreased movement - Parkinson’s Disease

Question 3

CNS:

What would be the presentation of pathology in the brainstem and cerebellum? Examples?

What would be the presentation of pathology in the spinal cord? Examples?

Answer 3

Motor and sensory (including face) - STROKE
Ataxia

Motor (excluding face as that is supplied by cranial nerves!!!!)
Sensory
Bladder
Bowel

MS

Question 4

CNS:

What would be the presentation of pathology in the caudal equina? Examples?

Answer 4

Motor
Sensory (lower limb)
Bladder
Bowel

Cauda equina syndrome

Question 5

PNS:

What would be the presentation of pathology at the anterior horn cells? Examples?

What would be the presentation of pathology at the nerve root? Examples?

Answer 5

Motor
Fasciculations

(MND)

Motor
Sensory
Pain

(Degenerative spine disease)

Question 6

PNS:

What would be the presentation of pathology at the peripheral nerve? Examples?

What would be the presentation of pathology at the neuromuscular junction? Examples?

Answer 6

Motor
Sensory
Hyporeflexia

(Guillian-Barre Syndrome)

Fatigability

(Myasthenia Gravis)

Question 7

PNS:

What would be the presentation of pathology at the muscle? Examples?

Answer 7

Proximal weakness
Wasting
Normal sensation

Idiopathic inflammatory myopathic