Neurology : Localization and Differential Diagnosis

Important Principles of Localization and Differential Diagnosis

A. Differentiate focal, multifocal, and diffuse processes.


B. Determine if the history and examination indicate a neurological disorder.


C. Differentiate anatomically, aphasia, dysarthria, and confusion.


D. Differentiate dominant hemisphere from nondominant hemisphere deficits.


E. Describe the anatomical basis for brainstem lesions with respect to crossed deficits and dysconjugate gaze.


F. Contrast conjugate gaze deficits for cortical vs. brainstem lesions.


G. Localize the following visual field deficits:


1. Deficits isolated to one eye

2. Bitemporal deficits

3. Homonymous deficits (e.g., homonymous hemianopsia)


H. Differentiate central from peripheral facial palsy.


I. Differentiate between an upper motor neuron (UMN) and a lower motor neuron (LMN) deficit with regard to patterns of weakness, muscle bulk, the presence of fasciculation, altered tone, reflex changes, and the plantar reflex.


J. Discuss the significance of a sensory level and dissociated sensory deficits (contralateral spinothalamic and dorsal column deficits).


K. List the major deficits due to cerebellar lesions and distinguish midline deficits from those of a hemisphere.


L. Define the characteristics of a lesion of the following:


1. Nerve root

2. Plexus

3. Peripheral nerve

4. Neuromuscular junction (NMJ)

5. Muscle