SUBJECTIVE EXAMINATION:

Symptoms may appear in LL with gait related changes:

-Upper motor neuron changes

-Dysfunctional corticospinal and spinocerebellar tract

Later on, lower motor neuron findings in UL

-Loss of strength

-Atrophy

-Fine finger movement difficulties

-Clumsiness

-loss of vibratory sense

-increased muscle tone

-tendon reflexe increased

SPECIAL TESTS:

-Peripheral neurological examination (dermatomes, myotomes, deep tendon reflexes)

-Upper motor neurons examination: Lhermitte sign, Hoffmann's test, Babinski's sign, Clonus, Romberg