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Sites of upper motor neurone signs

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The site of an upper motor neurone lesion determines the distribution of the deficit seen. Thus:

  • peripheral hemisphere lesion - this will cause a contralateral monoparesis

  • deep hemisphere lesion - this will cause a contralateral hemiparesis

  • cervical spinal cord lesion - causes a paraparesis

  • midbrain, pons, brainstem or upper cervical cord - this leads to a tetraparesis

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