Neuro Clinical Syndromes

Front 1

Loss of pain and temperature bilaterally at particular level

Back 1

Anterior commissure lesion around level of loss

Front 2

Loss of fine touch and position sense unilaterally extending down body

Back 2

Dorsal column lesion on ipsilateral above level of loss

Front 3

Loss of pain and temperature unilaterally extending down body

Back 3

Anterolateral column lesion contralateral at level of loss

Front 4

Loss of fine touch/position sense on one side of body extending down with combined loss extending a few levels up; loss of pain/temperature on opposite side

Back 4

Hemisection of cord at level of combined loss ipsilateral to combined loss/fine touch

Front 5

Stocking glove syndrome (loss of fine touch/position sense from hands and feet)

Back 5

Peripheral neuropathy (hits large myelinated fibers 1st)

Front 6

Loss of most unilateral sensation (retention of some pain) from body with some facial/perioral sparing

Back 6

Thalamic lesion contralateral to loss (facial sparing due to bilateral trigeminal projections)

Front 7

Hemineglect (neglect of 1/2 of body/space)

Back 7

Lesions of posterior parietal sulcus (region between areas 5 and 7) contralateral to neglect

Front 8

Overactive stretch reflex/clasp knife reaction

Back 8

Damage to descending motor control pathway, upper motor neuron syndrome

Front 9

Decerebrate response: extension of limbs and neck

Back 9

Damage to medial descending pathway/midbrain/upper pons causing overactive vestibulospinal response

Front 10

Decorticate response:
If head straight, flexed upper and extended lower limbs (reversed if patient turned upside down against gravity) If head turned, extention of limb looked at, flexion of other limb

Back 10

Lesion of lateral descending pathway/internal capsule causing overactive reflexes, especially vestibulospinal and tonic neck reflexes

Front 11

Hyperactive palpatory reflex/involuntary grasp reflex
or
Hyperactive resistance to limb displacement (gegenhalten)

Back 11

Anterior frontal lobe lesion (deprive corticospinal system of higher control)

Front 12

Parkinson's disease, involuntary flexion at many joints

Back 12

Substantia nigra degeneration, inability to focus globus pallidus internus output to select motor programs

Front 13

Huntington's chorea, involuntary movements resembling exaggerated normal movements, postural changes, hemiballismus/throwing objects

Back 13

Caudate, putamen, or subthalamic nucleus lesions (contralateral to affected side), inability to select desired motor program, inhibit postural reflexes

Front 14

Decreased ability to make automatic rapid, smoothly coordinated movements; decreased ability to learn new movements

Back 14

General cerebellar damage

Front 15

Falling to one side

Back 15

Damage to ipsilateral fastigius deep cerebellar nucleus

Front 16

Tremor during movement

Back 16

Damage to ipsilateral interpositus/intermediate/globose and emboliform deep nucleus of cerebellum

Front 17

Overshoot of target when reaching, inability to combine single digit movements

Back 17

Damage to ipsilateral dentate deep cerebellar nucleus

Front 18

Falling to side during heel-toe gait

Back 18

Ipsilateral midline cerebellar damage

Front 19

Central apnea in Parkinson's disease

Back 19

Degeneration of Pre-Botzinger cells

Front 20

Incontinence, frequent UTIs in parapalegics

Back 20

Loss of long loop micturation reflex (involves hypothalamus and PAG), difficulty reestablishing short loop reflex, incomplete bladder emptying

Front 21

Hoarse speech, dysphagia, nystagmus, ataxia; on one side, loss of gag reflex, loss of pain/temp from face, Horner's syndrome; on opposite side, loss of pain and temp from body

Back 21

Lateral medullary syndrome, occluded branch of PICA in open medulla, ipsilateral to loss of gag reflex

Front 22

Deviation of tongue to one side; on opposite side, loss of fine touch and vibration, limb paralysis, ataxia

Back 22

Medial medullary syndrome, occluded branch of AICA ipsilateral to tongue deviation

Front 23

Loss of gag reflex, dysphagia, hoarseness, weakness of sternocleidomastoid and upper trapezius; possible involvement of tongue

Back 23

Meningiomas inside base of skull compressing IX, X, and XI; outside the base of skull may also compress XII

Front 24

Initial Deafness, tinnitus, vertigo on one side; progressing to facial numbness, weakness of masseter and temporalis muscles, ataxia, limb weakness

Back 24

Acoustic neuroma (tumor of VIII)

Front 25

Adducted eye at rest/weak lateral rectus

Back 25

VI nerve palsy, VI often stretched, compressed, or inactivated by diseases causing increased cranial pressure, eg mass lesions in posterior fossa

Front 26

Internuclear opthalmoplegia (failure of coupling between lateral rectus of 1 eye and medial rectus of other eye)

Back 26

Occlusion of small basilar artery in pons infarcting medial longitudinal fasciculus; can be bilateral in multiple sclerosis

Front 27

Unilateral weakness of lower facial expression muscles

Back 27

Stroke involving contralateral input to VII nucleus

Front 28

Unilateral weakness of both upper and lower facial expression muscles

Back 28

Damage to ipsilateral nerve VII or motor neurons

Front 29

Loss of vestibulocular reflex, loss of lateral rectus, contralateral limb paralysis and loss of fine touch, ataxia

Back 29

Medial inferior pontine syndrome, occlusion of paramedian branches of basilar artery

Front 30

Hearing deficit, vertigo, facial paralysis, loss of pain and temperature from face, contralateral loss of pain and temperature from body

Back 30

Lateral inferior pontine syndrome, occlusion of AICA

Front 31

Facial paralysis, contralateral limb paralysis, ataxia

Back 31

Medial mid-pontine syndrome, occlusion of paramedian branches of basilar artery

Front 32

Weakened mastication, loss of facial sensation (ipsilateral)

Back 32

Lateral mid-pontine syndrome, occlusion of circumferential branches of basilar artery

Front 33

Loss of VOR, soft palate tremor, contralateral limb paralysis and loss of fine touch, ataxia

Back 33

Medial superior pontine syndrome, occlusion of paramedian branches of upper basilar artery

Front 34

Ataxia, contralateral loss of fine touch, pain, and temperature sensation from body

Back 34

Lateral superior pontine syndrome, occlusion of superior cerebellar artery

Front 35

Cerebellar ataxia, loss of fine touch to body and face, (contralateral), loss of pupil constriction, lateral strabismus

Back 35

Tegmental syndrome of midbrain, occlusion of paramedian branches of the basilar a. / posterior cerebral a

Front 36

Muscle paralysis, (contralateral), ipsilateral eye turns out loss of pupil constriction, lateral strabismus

Back 36

Ventral syndrome of midbrain, paramedian branches of the basilar a. / posterior cerebral a (eye turns out due to ipsilateral loss of medial rectus, inferior rectus, superior rectus, inferior oblique)

Front 37

Loss of up gaze, impaired convergence

Back 37

Tumor of pineal body

Front 38

Bilateral loss of pain and temperature at a particular level, muscle weakness/wasting at higher level

Back 38

Syringomyelia: cyst or cavity in spinal cord, begins in canal, expands to hit anterior commissure, then ventral horn

Front 39

Psychic blindness (inability to tell significance of objects), lack of fear response

Back 39

Bilateral amygdala lesions

Front 40

Deficit in anticipation of long-term consequences of an action

Back 40

Lesion of ventromedial prefrontal cortex

Front 41

Von Economo's encephalitis lethargica: 3 regions damaged involving sleep

Back 41

1. Upper pons transections, excessive sleep
2. Ventrolateral preoptic nucleus, important for initiating sleep
3. Orexin cells important for maintaining wakefulness lack of orexin-->narcolepsy

Front 42

Violent sleeping

Back 42

Lesion in caudal pons

Front 43

Blocked consolidation of new memories

Back 43

Damage to medial temporal lobe, especially hippocampus (CA1 very sensitive to ischemia, seizures) and parahippocampal gyrus (often invovled in more detailed memory)

Front 44

Korsakoff's syndrome (anterograde and retrograde amnesia, plus other symptoms)

Back 44

Lesion along 3rd ventricle involving medial thalamus and mammillary bodies, found in alcoholics, caused by vitamine B1 deficiency

Front 45

Difficulty with language output and grammar

Back 45

Left frontal cortex lesion (Broca's area)

Front 46

Difficulty with language comprehension, word salad

Back 46

Left temporo-parietal junction lesions (Wernicke's area)

Front 47

Inability to pronounce pseudowords (eg, "caik")

Back 47

Sublexical route damage

Front 48

Inability to correctly pronounce words that do not follow "sound it out" rules

Back 48

Lexical route damage