Neurology

UMN (Upper Motor Neuron)

Conductor of motor signals; deficits result in loss of signal, increased stride length, increased extensor tone, and normal/increased reflexes.

LMN (Lower Motor Neuron)

Orchestra of motor signals; deficits result in loss of power, decreased stride length, decreased extensor tone, and decreased reflexes.

UMN Weakness

Spastic paresis or paralysis with increased stride length and normal to increased reflexes.

LMN Weakness

Flaccid paresis or paralysis with decreased stride length and decreased to absent reflexes.

UMN Muscle Atrophy

None/mild atrophy occurs slowly due to disuse.

LMN Muscle Atrophy

Severe denervation atrophy occurs rapidly (5-7 days).

Generalized NM Disease

Diffuse weakness affecting multiple muscle groups.

Spinal Cord Disease

Localized deficits based on specific spinal cord segments affected.

Cerebellar Ataxia

Gait characterized by lack of coordination and balance, often with intention tremors.

Vestibular Ataxia

Asymmetric gait with head tilt and possible nystagmus.

Proprioceptive Ataxia

Generalized ataxia with abnormal limb placement and coordination.

Forebrain Disease

Altered mental status, contralateral blindness, and deficits in contralateral limbs.

Differential Diagnoses for Forebrain Disease

Includes degenerative, anomalous, metabolic, neoplastic, inflammatory, infectious, and traumatic causes.

Diagnostic Plan for Forebrain Disease

Blood tests, urinalysis, imaging (MRI), and CSF analysis.

Treatment for Forebrain Disease

Depends on underlying cause; may include corticosteroids, anticonvulsants, and supportive care.

Spinal Cord Localization

Identifying the specific spinal cord segment affected based on clinical signs.

Micturition Dysfunction

Characterized by either UMN or LMN dysfunction affecting bladder control.

UMN Bladder Dysfunction

Increased tone, difficult to express, and may have some leakage.

LMN Bladder Dysfunction

Hypotonic bladder, easy to express, and dribbling due to inability to constrict sphincters.

Differential Diagnoses for Micturition Dysfunction

Includes neurogenic causes (spinal cord lesions) and non-neurogenic causes (bladder pathology).

Treatment for UMN Bladder Dysfunction

α-antagonists and striated muscle relaxants.

Treatment for LMN Bladder Dysfunction

Parasympathomimetics to stimulate detrusor contraction.

Multifocal Disease

Clinical signs indicating multiple lesions within the nervous system.

Diagnostic Plan for Multifocal Disease

Bloodwork, imaging (MRI), and CSF analysis to identify underlying causes.

Treatment for Multifocal Disease

Immunosuppressive therapy for inflammatory conditions and supportive care.

Brain Injury Pathophysiology

Primary injury occurs at the time of trauma; secondary injury develops due to biochemical changes.

Increased ICP

Elevated intracranial pressure that can lead to brain herniation and death.

Triage for Head Trauma

Initial assessment focusing on ABCs (Airway, Breathing, Circulation) and stabilization.

Management of Head Trauma

Fluid therapy, oxygenation, and osmotherapy (mannitol or hypertonic saline).

Prognosis for Head Trauma

Dependent on severity, response to treatment, and trends in neurologic status.