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UMN Signs (Examination (Gait (Unilateral → circumducting, Bilateral →…
UMN Signs
Examination
Inspection
- Walking aids
- May have disuse atrophy and contractures
- Limb position
- Leg: extended, internally rotated c¯ foot plantar flexed
- Arm: flexed, internally rotated, supinated
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UMN Signs
- ↑ tone
- Pyramidal distribution of weakness
- Leg: extensors stronger than flexors
- Arm: flexors stronger than extensors
- Hyper-reflexia
- Extensor plantars
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Viva
Mx
Supportive
MDT: GP, neurologist, radiologist, neurosurgeon, specialist nurses, physio, OT
Orthoses
Mobility aids
Urinary: ICSC
Contractures: baclofen, botulinum injection, physio
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Hx
MS: tingling, eye problems, ataxia, other weakness
Cord compression: back pain, fever, wt. loss
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Unilateral LL
Hemisphere → Spastic Hemiparesis
Hemicord → Spastic Hemiparesis or Monoparesis