Table 2 Motor neuron signs and symptoms (according to gold Coast criteria [41])
Region | Upper motor neuron (UMN) | Lower motor neuron (LMN) |
|---|---|---|
Head | • slowed, poorly coordinated voluntary movement of the tongue (reduced range of motion, difficulty with lateral movements) • hyperreflexia of mandibular reflex (jaw jerk positive) • palatal spasticity (abnormal, uncoordinated or excessive movement of the palate) • snout reflex (pathological reflex) | • tongue wasting • palatal weakness and fasciculations |
Arm | • Increased velocity-dependent tone (spasticity) in hand and arm • slowed, poorly coordinated voluntary movement in hand, arm or shoulder • hyperreflexia • preserved reflexes in wasted or weak muscles • spread of reflexes to adjacent muscles • Hoffman´s sign (pathological reflex) | • weakness of hand, arm or shoulder muscles and muscle wasting • absent reflexes |
Trunk | • slowed, poorly coordinated voluntary movement during respiration or trunk movements • pathological paraspinal and abdominal reflexes | • weakness of paraspinal, costal and abdominal muscles and muscle wasting |
Leg | • Increased velocity-dependent tone (spasticity) in foot, leg or hip • slowed, poorly coordinated voluntary movement of foot, leg or hip • hyperreflexia • preserved reflexes in wasted or weak muscles • spread of reflexes to adjacent muscles • Babinski sign (commonly not present) • crossed adductor reflex | • weakness of foot, leg or hip muscles and muscle wasting • absent reflexes |