Neuro Test Forebrain Mid-Caudal Brainstem Cerebellar C1-C5 C6-T2 T3-L3 L4-S3 LMN

Behaviour Seizures; Abnormal; Depression- Coma Unaffected Normal Normal Normal Normal Normal
Propulsive activity; (NORMAL)
Depression->Coma
Posture/Gait Head turn; Normal UMN Intention tremor of Variable; Variable: Variable: UMN Variable: flaccid Variable: flaccid
gait (unless peracute tetraparesis/tetraplegia head, neck or eyesl Ranges from LMN gait in paresis/GP paraparesis and paresis in
lesion); Propulsive GP deficits opisthotonos and UMN thoracic limbs ataxia in pelvic GP ataxia in affected limb(s)
circling (usually Vestibular ataxia (pontine extensory rigidity of tetraparesis limbs through pelvic limbs through flaccid
ipsilateral) or Pacing and medullary lesions) all limbs with hips GP ataxia UMN paresis/GP spastic through flaccid paralysis of
Aimless wandering flexed (severe, rostral through spastic ataxia in pelvic paraplegia paraplegia affected limb(s);
Head pressing Opisthotonus (Midbrain lesions); truncal tetraplegia limbs through exercise may
Movement lesion) sway; spastic exacerbate the
disorders (rare) head tilt; tetraplegia paresis
hypermetric/spastic
gait with strength
preserved; loss of
balance
Postural Contralateral Ipsilateral deficits (pons Delayed and then Delayed to Delayed to Normal in Delayed to Delayed to
reactions deficits and medulla), exaggerated in all absent in all absent in all thoracic limbs; absent in pelvic absent in
Contralateral deficits limbs with diffuse four limbs four limbs delayed to limbs affected limb(s)
(Rostral midbrain) disease or in absent in pelvic Normal in ‘pure’
ipsilateral limb with limbs LMN disease if
unilateral lesions patient maintain
some voluntary
motor function
Muscle Normal Normal to increase Muscle tone may be Normal muscle Thoracic limn Normal tone in Normal tone in Decrease tone
mass/tone (All 4 limbs) exaggerated mass (mild neurogenic thoracic limbs thoracic limbs in affected
atrophy due to atrophy (chronic limb(s)
disuse in lesions); Normal to Reduced tone in Neurogenic
chronic dz) reduced tone in exaggerated pelvic limbs, atrophy may be
Normal to thoracic limbs; tone in pelvic reduced muscle severe; pseudo-
exaggerated normal to limbs; normal mass in pelvic hyperthrophy in
muscle tone in exaggerated muscle mass limbs (chronic)l certain
all 4 limbs; tone in pelvic unless disuse UMN (rare) or myopathies ;
Possible UMN limbs; possible atrophy in pelvic LMN bladder possible LMN
bladder UMN bladder limbs; possible bladder
UMN bladder
Spinal reflexes Normal Normal to increase Normal to Normal to Normal to Normal Hyporeflexia Variable:
(All 4 limbs) exaggerated increase in all 4 reduced withdrawal through hyporeflexia
limbs, may be withdrawal reflex in areflexia of through
associated with reflexes in thoracic limbs; patellar areflexia of
reduced thoracic limbs; Normal to affected limb(s)l
 withdrawal normal to exaggerated (L4-L6), possibly
reflexes in exaggerated patellar and withdrawal (L7- reduced
thoracic limbs patellar and withdrawal S1) and perineal perineal reflexes
withdrawal- reflexes in pelvic reflexes (S1-S3)
reflexes in pelvic limbs; (S1-S3)
limbs cutaneous
trunci “cut off”
may be present
slightly caudal
to the lesion
Cutaneous Contralateral (often Hypoalgesia to trunk and Unaffected Hypoalgesia Hypoalgesia or Normal in Normal in Normal in
sensation facial/nasal) limbs may be present caudal to a focal normal in all thoracic limbs; thoracic limbs, “pure” LMN dz
hypoalgesia (rare) lesion (rare) four limbs or hypoalgesia, normal, but if a
hypoalgesia in analgesia, or hypoalgesia or polyneuropathy
thoracic limbs normal in pelvic analgesia in with a sensory
only limbs pelvic limbs, tail, component,
perineum, anus hypoalgesia may
and penis be present
Cranial Nerves Contralateral Anisocoria (III, symp) Menace deficits Ipsilateral Ipsilateral Normal Normal Variable:
menace deficits with Dropped jaw (V, (Ipsilateral) miosis (rare due Horner’s multiple cranial
normal (optic bilateral); Mastication Anisocoria (unequal to UMN syndrome (T1- nerve may be
radiation and muscle atrophy (V); pupil size - rare) Horner’s T3) lesions affected
occipital cortex) or Facial hypoalgesia (V); syndrome)
abnormal (optic Head tilt (VIII); Resting or
chiasm, optic tracts) Positional nystagmus
PLRs; (VIII); Abnormal
Facial; tongue or physiologic nystagmus/
pharyngeal Resting or positional
weakness (rare) strabismus (III,IV,VI,VIII);
Facial paresis and
paralysis (VII), Dysphagia
(IX,X); Tongue paresis or
paralysis (XII)
Other Abnormalities in Respiratory and Cardiac A focal, severe A focal, severe L4-L7 lesions of L4-L7 lesions Laryngeal
thirst, appetite, abnormalities lesion between lesion between the white may produce paralysis,
thermoregulation these segments these segments matter may signs that mimic dysphagia,
may result in may result in produce similar T3-L3 megaesophagus
death due to death due to signs common in LMN
respiratory respiratory disease
dysfunction dysfunction