Lecture 41: Hemiparesis and Stroke

Question 1

What is hemiparesis and hemiplegia?

Answer 1

Hemiparesis = Weakness
Hemiplegia = No movement at all

Unilateral paralysis / weakness face, arm and leg

Question 2

What is paraparesis and paraplegia?

Answer 2

Bilateral weakness / paralysis of both legs

Question 3

What is the characteristic pattern of weakness for pyramidal lesion: Upper vs lower limbs

Answer 3

Upper limbs
- Flexor muscles may be weak but are stronger than the extensors

Lower limbs
- Extensor muscles may be weak but are stronger than the flexors. Ie leg is straight and gait may circumflex instead to avoid the foot scrap b/c dorsiflexion and leg extension. (obv sign of pyramidal distribution lesion when walk in)

Question 4

What is the characteristic posture and gait with pyramidal weakness?

Answer 4

• Upper limb held flexed
• Lower limb extended
• The person walks with a stiff leg and foot may scrape the floor

Question 5

What is the characteristic weakness of pyramidal lesions?

Answer 5

Pyramidal weakness is also associated with;

• Increased tone (spastic catch)
• Increased reflexes
• Extensor plantar response (Babinksi reflex)

‘pyramidal distribution weakness)

Question 6

Describe the pattern of LMN weakness:

Answer 6

Pattern depends on which nerve root or peripheral nerve is damaged i.e C5 nerve root lesion -> Shoulders abduction weakness

• Decreased tone
• Decreased reflexes
• Downwards plantar response

Question 7

NB go back over his clinical presentation and see if there are any additional notes that could be made

Answer 7

Remove this once done