Localization within the nervous system
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Cerebrum:
-Abnormal mental status or cognitive impairment
-Seizures
-Unilateral weaknessa and sensory abnormalities including head and limbs
-Visual field abnormalities
-Movement abnormalities (e.g., diffuse incoordination, tremor, chorea)
Brainstem:
-Isolated cranial nerve abnormalities (single or multiple)
-"Crossed" weaknessa and sensory abnormalities of head and limbs, e.g.,
-weakness of right face and left arm and leg
Spinal cord:
-Back pain or tenderness
-Weaknessa and sensory abnormalities sparing the head
-Mixed upper and lower motor neuron findings
-Sensory level
-Sphincter dysfunction
Spinal roots:
-Radiating limb pain
-Weaknessb or sensory abnormalities following root distribution
-Loss of reflexes
Peripheral nerve Mid or distal limb pain
-Weaknessb or sensory abnormalities following nerve distribution
-"Stocking or glove" distribution of sensory loss
-Loss of reflexes
Neuromuscular junction:
-Bilateral weakness including face (ptosis, diplopia, dysphagia) and proximal limbs
-Increasing weakness with exertion
-Sparing of sensation
Muscle
-Bilateral proximal or distal weakness
-Sparing of sensation
Ref: Harrison's Principles of Internal Medicine 17 th Edition
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