Weakness & Paralysis UMN vs LMN Lesion ( Internal Medicine ) by Dr Nishant Arya
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- Опубликовано: 9 сен 2024
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Weakness & Paralysis UMN vs LMN -
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Weakness and paralysis can arise from damage to either the upper motor neurons (UMNs) or lower motor neurons (LMNs), each presenting with distinct clinical features. Understanding the differences between UMN and LMN lesions is crucial for accurate diagnosis and treatment planning.
Upper Motor Neuron (UMN) Lesions
Definition: Involve damage to the motor pathways that originate in the cerebral cortex and descend to the spinal cord. These neurons influence the activity of the lower motor neurons.
Common Causes: Stroke, multiple sclerosis, cerebral palsy, traumatic brain injury, and spinal cord injury.
Clinical Features:
Weakness: Typically affects groups of muscles, often more pronounced in the upper limbs (extensors) and lower limbs (flexors).
Paralysis: Spastic paralysis, where muscles are stiff and resistant to movement.
Tone: Increased muscle tone (hypertonia), resulting in spasticity.
Reflexes: Hyperreflexia, with exaggerated deep tendon reflexes.
Babinski Sign: Positive Babinski sign (upward movement of the big toe when the sole of the foot is stimulated).
Atrophy: Muscle atrophy is minimal or absent, as the muscle itself remains innervated.
Lower Motor Neuron (LMN) Lesions
Definition: Involve damage to the motor neurons that directly innervate skeletal muscles. These neurons originate in the spinal cord or brainstem and extend to the muscles.
Common Causes: Poliomyelitis, amyotrophic lateral sclerosis (ALS), peripheral neuropathies, spinal cord injuries at the level of the LMNs, and Guillain-Barré syndrome.
Clinical Features:
Weakness: Typically affects individual muscles or specific muscle groups.
Paralysis: Flaccid paralysis, where muscles are weak and limp.
Tone: Decreased muscle tone (hypotonia), leading to flaccidity.
Reflexes: Hyporeflexia or areflexia, with diminished or absent deep tendon reflexes.
Fasciculations: Visible twitching of muscle fibers due to spontaneous firing of motor units.
Atrophy: Significant muscle atrophy occurs due to denervation and lack of stimulation.
Key Differences -
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UMN Lesion:
Spastic paralysis
Hypertonia
Hyperreflexia
Positive Babinski sign
Minimal atrophy
LMN Lesion:
Flaccid paralysis
Hypotonia
Hyporeflexia
Fasciculations
Significant atrophy
Conclusion -
Differentiating between UMN and LMN lesions is essential for clinical diagnosis and management of neurological conditions. While UMN lesions result in spasticity and hyperreflexia, LMN lesions are characterized by flaccidity, hyporeflexia, and muscle atrophy. Understanding these distinctions helps in targeting appropriate therapeutic interventions and improving patient outcomes. 🧠🩺
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Thank you so much sir❤❤❤❤❤🎉.... upload more vdo and ...aise hindi mein bol ke samjhiye easy lagta he
Sir when will be next lecture?? Can u share your whole month plan?
Reflex and tone is increased in AHC\MND other wise how will you apply elescorial criteria…… both UMN and. LMN to. Be present
When is next lecture m from fadalpur baghpat
Please tell in english
If u are taking lectures y don't u speak Englishre , pls avoid Hindi for lectures it's very difficult to follow ur lectures
We want both languages 😉
Mujhe hameshaa yahi sir chy cancel all other teachers lectures
Some patient standing before Deen dayal hospital