NEURO Localization

Neurologic Localization

Process of correlating neurologic symptoms and signs to specific neuroanatomic and neurophysiologic areas.

NeuroAxis

Concept of dividing the nervous system into functional regions for better localization of impairments.

Hard Signs

Clear impairments in motor, sensory, and reflex behaviors directly linked to specific brain region dysfunction.

Soft Signs

Minor, subtle abnormalities in motor coordination or sensory integration, not indicative of a clear pathology.

Cortical Brain

Involves consciousness, language, motor control, spatial attention, and sensory processing.

Subcortical Brain

Controls pyramidal and extrapyramidal functions, including movement regulation.

Brainstem

Includes midbrain, pons, and medulla; responsible for basic life functions and cranial nerve activity.

Cerebellum

Coordinates voluntary movement, balance, and fine motor control.

Spinal Cord

Transmits sensory and motor information between the brain and body; dysfunction leads to paralysis or sensory loss.

Peripheral Nerve

Controls sensation and movement in the body’s extremities; lesions can cause weakness and sensory loss.

Neuromuscular Junction

Site where nerve signals are transmitted to muscles; dysfunction leads to muscle weakness and fatigability.

Muscle

Skeletal muscle function; abnormalities often present as weakness and atrophy.

Pyramidal Pathway

Carries motor signals from the brain to muscles; damage causes weakness or paralysis.

Extrapyramidal Pathway

Regulates involuntary movements; damage can lead to tremors, rigidity, or dystonia.

Cortical Localization

Includes impairments in consciousness, language, sensory loss, and movement patterns.

Frontal Lobe

Responsible for motor control, planning, and language. Lesions cause apraxia, executive dysfunction, and weakness.

Temporal Lobe

Important for auditory processing, memory, and language. Lesions lead to Wernicke’s aphasia and memory issues.

Parietal Lobe

Involved in sensory processing and spatial awareness. Damage causes neglect, hemianopia, and sensory loss.

Occipital Lobe

Processes visual information. Lesions cause vision disturbances like homonymous hemianopia.

Gerstmann Syndrome

Associated with parietal lobe damage; includes right-left confusion, finger agnosia, agraphia, and acalculia.

Broca’s Aphasia

Nonfluent aphasia, where the patient has difficulty producing speech but understands language.

Wernicke’s Aphasia

Fluent aphasia, where speech is produced normally but lacks meaning; comprehension is impaired.

Arcuate Fasciculus

Connects Wernicke’s and Broca’s areas; damage causes conduction aphasia, with difficulty repeating words.

Apraxia

Inability to perform learned movements despite having the desire and physical ability to perform them.

Hemispatial Neglect

A failure to attend to one side of the body or visual field, often seen with right parietal damage.

Spatial Attention

The ability to orient attention to specific locations in space; deficits can cause neglect.

Pyramidal Signs

Motor deficits caused by damage to the pyramidal tract, including weakness and hyperreflexia.

Extrapyramidal Signs

Motor signs caused by damage to the basal ganglia, including tremors, rigidity, and involuntary movements.

Chorea

Rapid, involuntary, irregular movements, often caused by basal ganglia dysfunction.

Dystonia

Abnormal muscle contractions causing twisting and repetitive movements.

Parkinsonism

Characterized by tremors, rigidity, bradykinesia, and postural instability due to basal ganglia dysfunction.

Cerebellar Signs

Ataxia, dysmetria, and tremors caused by cerebellar damage, affecting coordination and balance.

Sensory Pathways

Includes the spinothalamic tract (pain, temperature) and the dorsal column (touch, proprioception).

Radicular Pain

Pain radiating along the course of a nerve root, often due to compression or inflammation.

Spinal Cord Localization

Damage to the spinal cord leads to sensory and motor deficits below the level of injury, including paraplegia or quadriplegia.

Brainstem Localization

Lesions in the brainstem cause crossed signs (ipsilateral cranial nerve dysfunction, contralateral body weakness).

Midbrain Lesions

Affect eye movements and consciousness; common signs include altered pupillary reactions and cranial nerve dysfunction.

Pons Lesions

Affect facial motor function and sensation, as well as coordination; may cause locked-in syndrome.

Medulla Lesions

Affect breathing, heart rate, and cranial nerve function; may cause respiratory failure or coma.

Crossed Signs

A clinical finding where one side of the body exhibits weakness or sensory loss, while the opposite side shows cranial nerve dysfunction.

Lateral Medullary Syndrome (Wallenberg Syndrome)

Caused by vertebral artery occlusion, resulting in dysphagia, ataxia, and ipsilateral facial pain.

Medial Medullary Syndrome

Caused by occlusion of the anterior spinal artery, leading to contralateral hemiparesis and sensory loss.

Ataxia

Lack of coordination of voluntary movements, typically due to cerebellar damage.

Nystagmus

Involuntary eye movements, often caused by cerebellar or brainstem dysfunction.

Apraxia

Inability to perform tasks or movements despite having the desire and physical ability to do them, often seen with cortical damage.

Radicular Pain

Pain caused by compression or irritation of a spinal nerve root.

Peripheral Nerve Dysfunction

Weakness, sensory loss, or autonomic disturbances caused by peripheral nerve damage.

Neuromuscular Junction Dysfunction

Fatigability and muscle weakness caused by disorders like myasthenia gravis.

Muscle Dysfunction

Symmetric, proximal weakness and atrophy, often caused by muscle diseases like muscular dystrophy.

Mononeuropathy

Dysfunction affecting a single peripheral nerve, leading to sensory or motor deficits in its distribution.

Polyneuropathy

Dysfunction of multiple peripheral nerves, often in a symmetrical distribution, commonly seen in diabetes.

Myopathy

Muscle weakness, often with absent deep tendon reflexes, caused by disorders like muscular dystrophy or inflammatory myopathy.