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Bilateral LMN palsy with tongue weakness, wasting and fasciculations. → Bulbar motor Neuron disease

Note

Bilateral LMN palsy ... differentiates this from an UMN ... fasciculations #LMN ... #CNXII #CN12 #clinical

Amyotrophic Lateral Sclerosis (ALS) Summary
ALS: combination of the clinical examination finding of amyotrophy with the pathologic

combination of the clinical ... cellular function Clinical ... , LMN and brainstem ... and LMN signs to ... Exam: clinical evidence

Upper Motor Neuron (UMN) lesions are lesions occurring anywhere in the CNS from the brain up

LMN syndromes are ... clinically characterized ... UMC & LMN lesions ... very different clinical ... #LMN #Muscleweakness

Tongue Fasciculations Secondary to Hypoglossal Nerve Damage

Most commonly associated with ALS - This LMN XII was

with ALS - This LMN ... #PhysicalExam #Clinical

Floppy Baby Syndrome
• Infantile Botulism
• Acute Flaccid Myelitis
• Guillain Barre
• Neonatal Myasthenia

Myasthenia Gravis Clinical ... is crucial • UMN ... LMN signs - Assess

Left Tongue Deviation caused by UMN XII palsy

Looks can be deceiving. The UMN innervation of most

Deviation caused by UMN ... The UMN innervation ... looks like a left LMN ... CT brain ⬇️ Dx- UMN ... #CNXII #palsy #clinical

Incomplete spinal cord syndromes (ISCS)
• Central - Small Lesion - Suspended sensory deficit, classic cape

lower extremities, LMN ... small band of LMN ... paraparesis (mixed UMN ... and LMN types) ... weakness (purely LMN

Spinal Cord Disorders - Differential Diagnosis Framework

Spinal cord neurological lesion:
Clinical findings:
• Symptoms and signs below

neurological lesion: Clinical ... : Areflexia UMN ... plantar response LMN

In this video, you see right sided atrophy, right sided deviation, and fasiculations R>L, indicating a

fasiculations = LMN ... #PhysicalExam #Clinical

Generalized Weakness - Differential Diagnosis Framework
"l feel weak":
• Infectious: Influenza, EBV, PNA, Bacteremia, Sepsis
•

Rhabdomyolysis, Critical ... Infection • Neuro: UMN ... stroke, tumor), LMN

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