Upper Motor Neuron Lesion - Symptoms

Symptoms

Changes in muscle performance can be broadly described as the Upper Motor Neuron Syndrome. These changes vary depending on the site and the extent of the lesion, and may include:

  • Muscle weakness. A pattern of weakness in the flexors (lower limbs) or extensors (upper limbs), is known as 'pyramidal weakness'
  • Decreased control of active movement, particularly slowness
  • Spasticity, a velocity-dependent change in muscle tone
  • Clasp-knife response where initial higher resistance to movement is followed by a lesser resistance
  • Babinski sign is present, where the big toe is raised (extended) rather than curled downwards (flexed) upon appropriate stimulation of the sole of the foot. The presence of the Babinski sign is an abnormal response in adulthood. Normally, during the plantar reflex, it causes plantar flexion and the adduction of the toes. In Babinski's sign, there is dorsiflexion of the big toe and abduction of the other toes. Physiologically, it is normally present in infants from birth to 12 months. The presence of the babinski sign after 12 months is the sign of a non-specific upper motor neuron lesion.
  • increase deep tendon reflex (DTR)
  • Pronator drift

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