NEUROLOCALIZATION
NEUROLOGICAL EXAM
Behavior changes
• Pacing
• Head pressing
Disruption of inhibitory input to red nucleusno signals from forebrain to
stop walking
Circling
Animal will circle toward side with lesion due to "hemineglect" phenomenon
Animal ignores one side of world since to them it no longer exists
• Aggression Blindness,
• Obsessiveness, Incontinence
Mentation changes.
Obtunded not fully aroused
Stuporous patient only responsive to noxious stimuli
Comatose patient has heart beat, but not necessarily responsive to
stimuli
• Seizures
Observe
• Behavior, mentation, gait, posture
Tools
T
There
•Surface with traction, reflex hammer.
hemostats, light source, funding exam lens, cotton ball
C1-C5
• Respiratory depression
C8-T2
Homer syndrome
Nerve root signature
Absent Cutaneous Trunci
T3-L3
UMN
forebrain, brainstem, cerebellum, 61-C5 spinal
Proprioceptive
•Patients will cross limbs and scuff and knuckle
paws Vestibular
Patients will drift
towards one side.
Usually has head tilt and nystagmus
Cerebellar ataxia
• Dismetria/ hypermetria-overflexion
/extension of limbs
Not uncommon to have more than one type!
Schiff Sherrington
• Spinal Shock
Cuteous Trunci Cutoff
L4-53
Abnormal anal tone
• Flaccid tail
POSTURE
• Decerebrate
Patient is rigid in all limbs often with opisthotonus
Lesion usually in midbrain.
Generally stuporous to comatose
Decerebellate
Rigid in thoracic limbs
Flexed pelvic limbs
Lesion to cerebellum
Alert to obtunded
Head turn
Head no longer in longitudinal axis
- Head tilt
Head no longer level along horizontal axis
Torticollis
Contracture or flexion of cervical muscles
Opisthotonus
Head in dorsoextension
Risus sardonicus
Lack of inhibition to facial nerve
causing contracture of facial muscles
Schiff Sherrington
Thoracic limbs have increased extensor
tone
Pelvic limbs are paretic to plegic
Spasticity
Secondary to UMN lesion
• Flaccid
Secondary to LMN lesion
Neck guarded
Secondary to cervical pain
Kyphosis
Secondary to thoracolumbar, abdominal pain or malformation