Neurology: Hemiparesis Causes and Localization

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Questions and Answers

Which neurological deficits can help localize the lesion in cases of hemiparesis?

Cognitive impairment only
Motor function loss only
Visual impairments only
Language disorders and visual field defects (correct)

A ‘pure motor’ hemiparesis is most likely caused by a lesion in which area?

Temporal lobe
Posterior limb of the internal capsule (correct)
Thalamus
Medulla oblongata

What is suggested if hemiparesis is present without cranial nerve signs or facial weakness?

A lesion in the high cervical spinal cord (correct)
A lesion in the midbrain
A lesion in the lumbar region
A lesion affecting the brainstem

What syndrome occurs with a high cervical spinal cord hemiparesis?

<p>Brown-Séquard syndrome (C)</p> Signup and view all the answers

Which type of paralysis consists of ipsilateral cranial nerve signs and contralateral hemiparesis?

<p>Crossed paralyses (D)</p> Signup and view all the answers

Flashcards

Hemiparesis

Weakness or paralysis affecting one side of the body, caused by damage to the upper motor neuron pathway.

What causes hemiparesis?

Damage to the upper motor neuron pathway above the midcervical spinal cord, often above the foramen magnum.

What additional neurological deficits can help localize the lesion causing hemiparesis?

A neurological deficit that suggests the lesion is in the cerebral cortex. Examples include speech difficulties and homonymous hemianopia.

What is a 'pure motor' hemiparesis?

A type of hemiparesis involving weakness in the face, arm, and leg occurring due to a discrete lesion in the posterior limb of the internal capsule, cerebral peduncle, or upper pons.

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What is Brown-Séquard syndrome?

Neurological findings of weakness (or paralysis) on one side of the body and a loss of sensation on the other side.

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Study Notes

Hemiparesis: Causes and Localization

Hemiparesis arises from upper motor neuron lesions above the midcervical spinal cord, usually located above the foramen magnum.
Accompanying neurological symptoms help pinpoint the lesion's location.
Language impairments indicate a cortical lesion.
Homonymous visual field deficits suggest a cortical or subcortical hemispheric lesion.
Isolated hemiparesis (affecting face, arm, and leg) commonly stems from small lesions within the posterior limb of the internal capsule, cerebral peduncle, or upper pons.
Some brainstem lesions lead to "crossed paralyses," featuring ipsilateral cranial nerve signs and contralateral hemiparesis.
Absence of cranial nerve signs or facial weakness implies a high cervical spinal cord lesion, especially when combined with Brown-Séquard syndrome.
Brown-Séquard syndrome involves ipsilateral loss of joint position and vibration senses and contralateral loss of pain and temperature sensations.