Class

Description

Risk Factors

Common Symptoms

Examples

Upper Motor Neuron Disease

Lesions in descending motor tracts

Includes the cerebral cortex, internal capsule, brainstem, and spinal cord

Hemodynamic compromise

Diabetes

Cardiovascular disease

Advanced age

Closed head injury

Arteriovenous malformation

Weakness of many involved muscles

Hypertonicity (increase in muscle tone)

Hyperreflexia (exaggerated responses of spinal reflexes)

Pathological reflexes

Spasticity

Cerebral Vascular Accident (CVA) ("stroke")

• ischemic (low oxygen)
• hemorrhagic (bleeding)
• Subdural
• Subarachnoid
• Transient Ischemic Attack (TIA)

Cerebral Palsy

Spinal Cord Injury

Multiple Sclerosis

Lower Motor Neuron Disease

Lesions involving nerves and axons at or below the alpha motor neurons

Under investigation

Suggested linkages include genetic and environmental triggers 

Weakness of single or multiple involved muscles

Hypotonicity (decrease in muscle tone)

Fasciculations (small, local, involuntary contractions)

Muscle atrophy

Decreased or absent reflexes

Amytrophic Lateral Sclerosis (ALS)

Myasthenia Gravis

Guillian-Barre Syndrome

Disorders of the Basal Ganglia

Lesion of specific deep nuclei (centers) in the brain 

Characterized by either 1) large involuntary movements (dyskinesias) or 2) abnormal static postures (akinesias)

Under investigation. Hereditary factors; Long-term use of anti-psychotics 

Dyskinesias

Resting tremor

Athetosis (slow, involuntary, writhing, twisting movement)

Chorea (involuntary, continuous, rapid, irregular and jerky movements)

Akinesias

Rigidity (resistance to passive movement of the limb)

Dystonia (involuntary adoption of abnormal postures)

Bradykinesia (decreased amplitude and velocity of movement; slowed movements)

Parkinson's Disease

Huntington's Disease

Hemiballismus 

Disorders of Cerebellum

Lesion in the cerebellum

Much like CVA risk factors

Congenital malformation

Genetic contributors

Changes are ipsilateral (same side)

Ataxia

Dysmetria

Dysdiadochokinesia

Hypotonia

Speech changes

Cerebellar stroke

Ataxia disorders

Peripheral nerve disorders

Localized or diffuse trauma to the nerve structure

Repetitive use

Traction (stretching forces) from trauma

Difficult birth

Prolonged compression

Weakness in select muscle groups

Atrophy

Persistent pain

Carpal tunnel syndrome

Tarsal tunnel syndrome

Ischemic

Hemorrhagic

Most common (about 80% incidence)

Less common

Caused by emboli or arterial narrowing

Caused by rupture of vessels

Damage follows vascular distribution

Damage can extend into multiple vascular territories

Symptoms of stroke develop and worsen over time

Symptoms are usually sudden

Warning symptoms (changes in vision, balance, cognition, speech) often precede ischemic stroke

Warning symptoms (vomiting, severe headache, impaired

consciousness) often precede hemorrhagic stroke

Impairments are somewhat predictable

Impairments will vary with the individual and size

Right CVA

Left CVA

L sided paresis (neurological weakness)

R sided paresis (neurological weakness)

Decreased attention span

selective awareness of the environment or responsiveness to a stimulus or task without being distracted by other stimuli

Decreased initiation of tasks

Decreased awareness and judgment

Decreased R and L discrimination

Memory deficits

Dysphagia -

impairment of strength and coordination of chewing and swallowing

L hemianopsia -

loss of left half of the visual field

R hemianopsia -

loss of right half of the visual field

L inattention

Increased frustration

Decreased abstract reasoning

Apraxia -

inability to perform skilled purposeful movements

Emotional lability

Aphasia -

inability to produce functional (expressive) or integrate (receptive) speech

Impulsivity

Compulsive behavior

Decreased spatial orientation