Brain |
Vascular | Bilateral motor strip, centrum semiovale, corona radiata, internal capsule infarction, or hemorrhage; azygous ACA with ACA stroke; subdural hemorrhage; bilateral/central pontine infarctions, hemorrhage; MCA-ACA watershed infarction can cause “man in a barrel” syndrome with proximal arm and proximal leg weakness | Bilateral cortical or subcortical infarction, hemorrhage; bilateral brainstem infarctions, hemorrhage |
Infection/Inflammation | Bilateral motor strip, centrum semi- ovale, corona radiata, or internal capsule abscess, demyelinating disease; bilateral/central pontine abscess, demyelinating disease, basilar meningitis, sarcoid | Bilateral cortical or subcortical infarctions; bilateral brainstem infarctions, abscess, demyelinating disease, basilar meningitis, sarcoid, rhombencephalitis |
Neoplasm | Paramedian/falcine tumor; bilateral motor strip, centrum semiovale, corona radiata, internal capsule or pontine tumor, carcinomatous meningitis | Bilateral cortical, bilateral subcortical infarctions or brainstem tumor, carcinomatous meningitis |
Drugs | Accidental ingestion: carbon monoxide poisoning (globus pallidus injury), methanol poisoning (putaminal injury) | |
Idiopathic/Iatrogenic | Seizure with Todd paralysis | Bickerstaff-Cloake brainstem encephalitis |
Congenital/genetic | Alternating hemiplegia of childhood, migraine with hemiplegia, progressive bulbar palsy | Leukodystrophy |
Autoimmune | | Bilateral MS lesions, ADEM, acute hemorrhagic encephalomyelitis, tumefactive MS, vasculitis, Behçet syndrome |
Trauma | | Bilateral trauma |
Endocrine/metabolic | Central pontine myelinolysis | Global insult (typically accompanied by mental status changes): hypoxic ischemic encephalopathy, hypoglycemia |
Spinal Cord |
Vascular | | Infarction either due to embolic phenomenon or watershed infarction (greatest risk at level T4-8). Cardiothoracic and aortic surgery pose particular risks. Infarction in the territory of the artery of Adamkiewicz spares the dorsal columns. Vascular malformations |
Infection/Inflammation | Poliomyelitis/postpolio syndrome, West Nile virus | Infectious myelopathy or intra-axial abscess (bacterial, fungal, mycobacterium, viral, parasitic), sarcoid, HIV, HTLV-1, -2, syphilis |
Neoplasm | | Tumor (metastatic, primary such as astrocytoma, or ependymoma), paraneoplastic syndrome |
Drugs | Lead poisoning | Nitric oxide poisoning (mimics B12 deficiency, subacute combined degeneration) |
Idiopathic/Iatrogenic | Motor neuron disease (ALS), Hopkins syndrome (acute postasthmatic amyotrophy), monomelic amyotrophy, progressive lateral sclerosis, progressive muscular atrophy | Radiation myelopathy |
Congenital/genetic | Hereditary spastic paraplegia, familial spinal atrophy | Friedreich ataxia, adrenoleukodystrophy |
Autoimmune | | Immune-mediated myelopathy (transverse myelitis, multiple sclerosis, neuromyelitis optica), ADEM |
Trauma | | Direct trauma or nontraumatic compressive myelopathy (due to bony elements or extra-axial mass, tumor, abscess, hemorrhage) |
Endocrine/metabolic | | Vitamin B12, vitamin E deficiency |
Peripheral Nerve |
Vascular | | Vasculitic neuropathy |
Infection/Inflammation | | CMV radiculitis, diphtheria, HSV, VZV, EBV, leprosy, sarcoid, Bartonella, Sjögren syndrome, Lyme disease, syphilis |
Neoplasm | | Paraneoplastic, myeloma, amyloid, carcinomatous meningitis |
Drugs | Suramin, dapsone | Oxaliplatin, Taxol, aurothioglucose, arsenic, thallium |
Idiopathic/Iatrogenic | | CIP, radiation neuropathy |
Congenital/genetic | Porphyria | Charcot-Marie-Tooth disease |
Autoimmune | GBS | GBS, form fruste CIDP |
Trauma | Compressive neuropathy (neurapraxia, axonotmesis, nerve transection (neurotmesis) | Compressive neuropathy (neurapraxia, axonotmesis, nerve transection, neurotmesis) |
Endocrine/metabolic | Diabetic amyotrophy | |
Neuromuscular Junction |
Vascular | - | |
Infection/Inflammation | - | |
Neoplasm | Lambert-Eaton syndrome | |
Drugs/toxins | Botulism, organophosphate poisoning, penicillamine-induced myasthenia, tick paralysis, snake venom, hyper- magnesemia/hypocalcemia, neurotoxic fish poisoning | |
Idiopathic/Iatrogenic | Prolonged neuromuscular blockade (particularly from amino steroid paralytic agents) | |
Congenital/genetic | Congenital myasthenia | |
Autoimmune | MG | |
Trauma | | |
Endocrine/metabolic | | |
Muscle | | |
Vascular | Diabetic muscle infarction | |
Infection/Inflammation | Polymyositis, dermatomyositis, inclusion body myositis, viral, bacterial, or parasitic myopathy | |
Neoplasm | Paraneoplastic dermatomyositis, acute necrotizing myopathy, paraneoplastic neuromyotonia (Isaac syndrome), cachectic myopathy | |
Drugs/toxins | Alcohol, glucocorticoids, cocaine, antimalarial drugs, antipsychotic drugs, colchicine, antiretroviral drugs | |
Idiopathic/Iatrogenic | Critical illness myopathy, cachexia | |
Congenital/genetic | Mitochondrial myopathy (MERRF), glycogen storage disease, disorders of lipid metabolism, adult-onset acid maltase deficiency, periodic paralysis | |
Autoimmune | Interferon alpha, penicillamine-related myopathy | |
Trauma | Rhabdomyolysis | |
Endocrine/metabolic | Hyperthyroid/hypothyroid, Cushing, hyperaldosteronism with myopathy, hyperparathyroid myopathy, hypokalemic myopathy | |