Localization of Symptoms
Try and think about neurological problems from an anatomical point-of-view. Split the nervous system up into parts and ask yourself, “Could the patient’s symptoms be produced by this part of the nervous system”? You will usually find that this approach can easily eliminate a long differential list. Keep in mind that there are exceptions to every rule in neurology.
| ANATOMY | FUNCTION |
| Brain | Often unilateral Motor and/or sensory Language Vision Memory Behavior Consciousness Seizures |
| Brain stem | Often unilateral Motor and/or sensory Cranial nerves: diplopia, vertigo, hearing, swallow, etc. Cerebellar Consciousness |
| Spinal cord | Bilateral symptoms common Motor and sensory, usually both Head OK Bowel, bladder and erectile |
| Motor neuron | Asymmetric bilateral Motor only Proximal and distal muscles Slowly progressive Fasciculations |
| Peripheral nerve | Symmetric or focal Sensory > motor Often distal in stocking/glove distribution |
| Neuromuscular junction | Asymmetric bilateral Motor only Proximal and distal muscles Fatigable weakness and eye involvement in MG |
| Muscle | Symmetric bilateral Motor only Usually proximal |