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Symptoms and Signs – Differential Diagnosis of Muscle Weakness, Lower Motor Neuron Versus Upper Motor Neuron
LOWER MOTOR NEURON
• Weakness, usually severe
• Marked muscle atrophy
• Fasciculations
• Decreased muscle stretch reflexes
• Clonus not present
• Flaccidity
• No Babinski’s sign
• Asymmetric and may involve one limb only in the beginning to become generalized as the disease progresses
UPPER MOTOR NEURON
• Weakness, usually less severe
• Minimal disuse muscle atrophy
• No fasciculations
• Increased muscle stretch reflexes
• Clonus may be present
• Spasticity
• Babinski’s sign
• Often initial impairment of only skilled movements
• In the limbs, the following muscles may be the only ones weak or weaker than the others: triceps; wrist and finger extensors; interossei; iliopsoas; hamstrings; and foot dorsiflexors, inverters, and extroverters
LOWER MOTOR NEURON
• Weakness, usually severe
• Marked muscle atrophy
• Fasciculations
• Decreased muscle stretch reflexes
• Clonus not present
• Flaccidity
• No Babinski’s sign
• Asymmetric and may involve one limb only in the beginning to become generalized as the disease progresses
UPPER MOTOR NEURON
• Weakness, usually less severe
• Minimal disuse muscle atrophy
• No fasciculations
• Increased muscle stretch reflexes
• Clonus may be present
• Spasticity
• Babinski’s sign
• Often initial impairment of only skilled movements
• In the limbs, the following muscles may be the only ones weak or weaker than the others: triceps; wrist and finger extensors; interossei; iliopsoas; hamstrings; and foot dorsiflexors, inverters, and extroverters
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