Motor defects

Clinical features of different types of motor defect

 Neurology  MRCP

Pyramidal (upper motor neurone) lesionlower motor neurone lesionExtrapyramidal defectCerebellar defectFactitious motor defect
inspectionslight atrophy, pronator driftmarked atrophy, FASCICULATIONresting tremor, dyskinesiatitubation, NYSTAGMUS, dysarthria, ataxiamay have abnormal posture
toneSPASTIC (clasp knife) esp. anti-gravity musclesdecreased'LEAD PIPE' rigiditydecreasednormal
powerDecreased (diffuse muscle groups)Decreased (individual muscle or myotomes)Akinesia or bradykinesiadecreased (diminished effective movement)decreased, Hoover's sign
Coordinationpoorpoorpoorpoor, intention tremor, ataxia, Rhomberg's -vepoor
ReflexesINCREASED, clonus, absent abdominal reflexesDECREASEDincreased / normaldecreasednormal
PlantarsUPdown / absentdowndowndown
Important causesstroke, spinal cord (below the lesion)peripheral nerve lesion / motor neuropathy, motor neurone disease, spinal cord (at the level of the lesion)Parkinson's diseasealcoholic cerebellar degeneration and other toxinspersonality disorder, abuse
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