neurology and the importance of localization

[bulldog]

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It's been stressed by all the residents that u need to be able to localize. say if a patient w/ a hx of MS presents w/ decreased strength in his legs, but intact sensation, slightly brisk reflexes, u'd put recurrence as a most likely ddx. in terms of localizing the lesion, what can u comment on the region if no radiographic studies have been done?

 

[mpp]

There are plenty of basic books that go over localization in neurology. I think there is one called "Localization in Clinical Neurology".

Theoretically it's a straightforward thing to do. You are localizing to levels such as supratentorial, infratentorial/posterior fossa, spinal, peripheral nerve and so on. You should be able to do so from the sign and symptoms. For example, a spinal lesion should show a definite level and affect both motor and sensory.

Furthermore, you should be able to delineate the general category of lesion (vascular, neoplasm, etc.) from the temporal characteristics of the symptoms..

 

[SurgONC]

Just an FYI - spinal lesion do not have to effect both motor and sensory (i.e. tabes dorsalis).