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Pediatric emergency medicine trisk 2638 2638

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DISORDERS OF MOTOR FUNCTION (SEE ALSO CHAPTER 82 WEAKNESS ) Goals of Treatment Weakness or motor deficits are often a sign of a significant underlying illness The primary goals of treatment should be early recognition of life-threatening conditions such as spinal shock and ascending paralysis Treatment should then focus on assessment of the pattern of motor deficit and anatomic localization in order to identify the underlying etiology Every level of the neural axis is involved in the performance of motor tasks Paresis refers to partial or complete weakness of a part of the body Various clinical designations are used to describe patterns of weakness: paraplegia (or paraparesis), affecting the lower half of the body; quadriplegia, affecting all limbs; and hemiplegia, referring to weakness of one side of the body Paraplegia most often results from spinal cord involvement, whereas hemiparesis is most often a sign of cortical disease TABLE 97.8 LOCALIZING LEVEL OF NEUROMOTOR DYSFUNCTION CLINICAL PEARLS AND PITFALLS Anatomic localization is usually possible after evaluation of the distribution and character of the deficit ( Table 97.8 ) MRI of the spine is the imaging modality of choice to detect compressive mass lesions Spinal Cord Dysfunction

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