Lower motor neuron symptoms
Weakness and muscle wasting are common when lower motor neuron involvement predominates. The patient or physician usually notices fasciculation, or muscle twitching. Fasciculation is a sign of muscle irritability, as the normal action of the lower motor neuron on the muscle is impaired. The sole involvement of lower motor neurons can be seen in a form of ALS called progressive muscular atrophy. Fasciculation is described as "benign" if there is no muscle weakness, atrophy, or impairment of motor function. Fasciculation is described as "pathologic" when it occurs in ALS with other symptoms.
Upper motor neuron symptoms
Spasticity, or stiffness, in the lower limbs, face, or jaw indicates upper motor neuron involvement. Spasticity in the legs often produces severe walking difficulties. The patient may complain of heaviness, fatigue, stiffness, or lack of coordination of any affected limb. Reflexes are very brisk, or exaggerated. Outbursts of laughter or crying with minimal provocation can occur. This is called emotional lability and is referred to as a pseudo-bulbar affect. Both brisk reflexes and emotional lability involve the inability to inhibit reflexes.
umn
symptoms
weakness,inco-ordination,stiffness,slowing of distal movement
signs
spasticity,brisk reflexes,babinski and hoffman signs,weakness and pseudobulbar palsy.
lmn
symptoms
fatigue,weakness,cramps,muscle twitching,inco-ordination.
signs
weakness,atrophy,fasiculations,suppression of reflexes,hypotonia.
