Upper motor neuron lesion

Upper Motor Neuron Lesion


Upper motor neuron lesion

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An upper motor neuron lesion is a lesion of the neural pathway above the anterior horn cell or motor nuclei of the cranial nerves. This is in contrast to a lower motor neuron lesion, which affects nerve fibers traveling from the anterior horn of the spinal cord to the relevant muscle(s).

Upper motor neuron lesions occur in conditions affecting motor neurons in the brain or spinal cord such as stroke, traumatic brain injury and cerebral palsy.


Changes in muscle performance can be broadly described as the Upper Motor Neuron Syndrome. These changes vary depending on the site and the extent of the lesion, and may include:

  • Muscle weakness. A pattern of weakness in the flexors (lower limbs) or extensors (upper limbs), is known as 'pyramidal weakness'
  • Decreased control of active movement, particularly slowness
  • Brisk tendon jerk reflexes
  • Spasticity, a velocity-dependent change in muscle tone
  • Clasp-knife response where initial higher resistance to movement is followed by a lesser resistance
  • Babinski sign is present, where the big toe is raised (extended) rather than curled downwards (flexed) upon appropriate stimulation of the sole of the foot. The presence of the Babinski sign is an abnormal response in adulthood. Normally, during the plantar reflex, it causes plantar flexion and the adduction of the toes. In Babinski's sign, there is doriflexion of the big toe and abduction of the other toes.......
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