UMN VS LMN LESIONS

• UPPER MOTOR NEURONE SIGNS

• Indicate that the lesion is above the anterior horn cell (i.e. spinal cord,
brain stem, motor cortex).
• Are characterised by increased muscle tone (spasticity), weakness
(generally flexors weaker than extensors in the legs and the reverse in the
arms - pyramidal pattern of weakness), increased reflexes, an up-going
plantar response and sustained clonus (a few beats is normal).
• LOWER MOTOR NEURONE SIGNS
• Indicate that the lesion is either in the anterior horn cell or distal to the
anterior horn cell (i.e. anterior horn cell, root, plexus, peripheral nerve).
• Characterised by decreased muscle tone, weakness and wasting (atrophy)
in the muscle(s) supplied by that motor nerve, arreflexia (absence of the
relevant reflex - the motor nerve is the efferent arm of the reflex arc),
muscle fasciculations.
Facial Nerve Lesion
• Upper motor neuron lesion
• Contralateral lower quadrant weakness
• Angle of the mouth
• Opposite side
• Lower motor neuron lesion
• Ipsilateral orbicularis oculi muscle and facial muscles involved
• Half of face
• unable to close eyes
• weakness of angle of the mouth
• cannot elevate eyebrows
• Same side
• Examples of UMN:
- Cerebrovascular accident
• Stroke is the most common
- Intracranial tumour
- Cervical spine injury
- Cerebral Palsy
• Examples of LMN:
- Motor neuron disease - Peripheral nerve neuropathy
- Poliomyelitis  anterior horn cell affected
- Spinal cord injury with nerve root compression
- Guillain-Barré syndrome - C. botulism
- Cauda equina syndrome