A 53-year-old male complains of difficulty walking and right lower extremity weakness. Stroking the sole of the right foot with a pen elicits toe extension. Which of the following additional findings is likely in this patient?
A. Muscle atrophy
B. Muscle fasciculations
C. Cogwheel rigidity
D. Hyperreflexia
E. Positive straight leg raise test
d. Hyperreflexia
Clue=babinski sign +
Lesions Concept, LMN vs UMN
LMN
Flacid paralysis / Hypotonia / Hyporeflexia / Muscle Atrophy
UMN
Hyperreflexia / Clasp knife rigidity / Babinski +/ Spastic paralysis (see in CorticoSpinal Tract demylination)
LMN
Seen with damage of the ventral Horn ( we have a BUNCH of causes) ex. Congenital (Wernig Hoffman) floppy baby
UMN
Seen with damage to the corticospinal tract
,,,,could be because of any demylinating disorder
Trauma/stroke involving the circle of willis
Damage to the internal capsule as well
Perfect! Yes its a UMN lesion.
everything with UMN is hyper or increased and everything with LMN is low and depressed.
Good job guys !
One more thing to add on : UMN lesions features ( hyperreflexia, spastic paralysis/limb weakness) are also called pyramidal signs.