Localizing Neurological Lesions
Copyright 2002 by John Tennison, MD
Lesion
Location
|
Deficit
|
Notes
|
Cerebral
Cortex
|
Sensory/Motor
Deficits contralateral to lesion.
Unlike Internal Capsule lesion, can have higher-level deficit, like aphasia,
agnosia, or apraxia. |
Lesions
here do not result in crossed deficits as seen in brain stem and spinal
lesions. |
Internal
Capsule
|
Sensory/Motor
Deficits contralateral to lesion. |
Lesions
here do not result in crossed deficits as seen in brain stem and spinal
lesions. |
Cerebellum
|
Motor
Problems: awkward intentional
movements |
|
Basal
Ganglia
|
Motor
Problems: meaningless, unintentional,
unexpected movements |
|
Brain Stem(Unilateral) |
Contralateral
Upper Motor Neuron Paralysis. Contralateral
proprioceptive and pain-temperature loss below the head. Ipsilateral cranial nerve deficits. |
If
cranial nerve involved, then lesion is above foramen magnum. |
Spinal Cord (Unilateral) |
Ipsilateral
paralysis and proprioceptive loss. Contralateral
pain-temperature loss below level of lesion. |
Radicular
pain suggests lesion is below the foramen magnum. |
Spinal
Nerve Root
|
Usually
more than 1 root severed will result in motor/sensory deficits in the pattern
of 1 or more dermatomes, which have a repetitive banding pattern, unlike the
seemingly random distribution of peripheral nerve areas. |
If
only 1 nerve severed, little if any motor/sensory defect because of overlap
of distribution in adjacent roots. |
Peripheral
Nerve
|
Pattern
of motor or sensory loss that is not in the form of a band characteristic of
a dermatome, but instead is in an asymmetric, often discontinuous areas. |
They
have a patchy distribution since a peripheral nerve is a mixture of contributions
from several nerve roots. |