Brain, Vol. 112, No. 3, 749-763, 1989
© 1989 Guarantors of Brain
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THE DISTRIBUTION OF MUSCULAR WEAKNESS IN UPPER MOTOR NEURON LESIONS AFFECTING THE ARM
Unit of Clinical Neurophysiology, Department of Neurology, The Prince Henry Hospital, School of Medicine, University of New South Wales Sydney, Australia
Correspondence to:
Correspondence to: Dr S C Gandevia, Unit of Clinical Neurophysiology, The Prince Henry Hospital, PO Box 233, Matraville, Sydney, NSW 2036, Australia
SUMMARY
The strength of 12 muscle groups of the arm was measured to determine the distribution of upper motor neuron weakness in man. Three groups of subjects were studied 14 intact volunteers (both sides recorded), 10 patients with unilateral arm paresis (both sides recorded) and 6 patients with severe paralysis of the arm (the ‘intact’ arm only measured). On the side contralateral to the causative lesion the pattern of weakness was not the same in all patients. Shoulder muscles were relatively spared while the wrist and finger flexors were relatively severely affected, the difference being statistically significant. In hemiparetic and hemiplegic patients the strength of muscles ipsilateral to the lesion was reduced compared with normal controls. These observations refine previous clinical descriptions of upper motor neuron weakness and have implications for its pathophysiology.
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Received May 10, 1988. Revised September 27, 1988. Accepted October 7, 1988.
1Present address: Institute of Neurology, The National Hospital for Nervous Diseases Queen Square, London WC1 3BG, UK.
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