a Pyramidal Signs, can be caused by both UMN signs and LMN signs

• vs clumsiness (coordination problem), Fatigue

| Upper Motor Neuron (CNS) | Peripheral Nervous System→ See ‣ | Both | | --- | --- | --- | | Brain | Nerve Roots | Motor Neuron Disease | | Spine | Plexi | Spine compression (both affecting cord and nerve roots) | | | Nerves | Other (e.g. B12, copper deficiency with peripheral neuropathy and myelopathy) | | | Neuromuscular Junction | Rare:Mitochondrial disorders | | | Muscle | |

Acute Weakness DDx

• Hyper-acute: !Stroke (CVA)
• !Myelopathy
• !GBS - Guillain-Barré syndrome
• MG - Myasthenia Gravis - no sensory signs
• West nile virus infection - no sensory signs
• MS - Multiple Sclerosis exacerbation

Chronic Weakness DDx

• Peripheral Neuropathy

• Muscular dystrophy

• Myopathy

  • Inflammatory Myositis

• ALS → UMN + LMN

• Tumor

  

History

• Location: Patients should be able to tell you which limb(s) is/are affected