• A 62-year-old man is in the stroke unit after experiencing a severe right-sided middle cerebral artery stroke. On physical exam there is left-sided upper extremity muscle weakness. The affected arm has increased muscle tone, and the bicep and tricep tendon reflex is 3+. There is also a left-sided Hoffman's sign.
  • Upper motor neurons
    • are neurons from the cerebral cortex to the anterior horn
  • Lower motor neurons
    • are neurons from the anterior horn to the peripheral muscle
Motor Neuron Signs
Clinical Features
Upper motor neuron signs
  • Weakness
  • Increased muscle tone
  • Hyperreflexia
  • Babinski's sign
  • Hoffmann's sign
  • Posturing
Lower motor neuron signs
  • Weakness
  • Atrophy
  • Fasciculations
  • Decreased tone
  • Hyporeflexia

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