Richard Sloop - Neurologic Localization

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R. Richard Sloop, M.D.

Neurologic Localization
Cortical focal signs and symptoms, seizures, aphasia, cognitive impairment, behavior and personality change 1. Stroke 2. Tumor Subcortical focal signs and symptoms without the other cortical features 1. Stroke 2. Multiple Sclerosis Brain Stem diplopia, vertigo, dysphagia, hoarseness, hearing loss, Horners, long tract signs, crossed findings 1. Stroke 2. Multiple Sclerosis 3. Tumor Spinal Cord crossed signs (Brown- Sequard), bowel and bladder, sensory level 1. Cervical Myelopathy 2. Acute Myelopathy (e.g. CA or transverse myelitis) 3. B12, etc. Anterior Horn mixture of upper and lower motor neuron abnormalities common 1. Motor Neuron Disease 2. Polio 3. West Nile Virus Nerve Root asymmetric, painful, radicular 1. Cervical Radiculopathy 2. Lumbar Radiculopathy 3. Neurogenic Claudication Peripheral Nerve symmetric, distal, stocking glove, motor and sensory, neuropathic pattern, decreased DTRs 1. Peripheral Neuropathy a. Acquired b. Inherited 2. Plexopathies a. Neuralgic Amyotrophy (UE) b. Diabetic Amyotrophy (LE) 3. Focal Neuropathies (CTS, radial, ulnar, peroneal, lateral femoral cutaneous, Bells palsy, trigeminal neuralgia)

R. Richard Sloop, M.D.

Neuromuscular Junction preserved reflexes, bulbar involvement, weakness without sensory loss 1. Myasthenia Gravis 2. Lambert Eaton 3. Botulism Muscle myopathic pattern, no sensory findings, elevated CK 1. Acquired a. Inflammatory (Dermatomyositis, Polymyositis, Inclusion Body Myositis) b. Metabolic / Toxic c. Infectious 2. Inherited (i.e. muscular dystrophy) a. Myotonic Dystrophy b. Duchenne Muscular Dystrophy c. Etc. Psychological long list of complaints, positive ROS, inconsistent exam, defies localization

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