Upper motor neuron, UMN

Clinic

• Upper Motor Neuron Pathways are first-order neurons, responsible for carrying signals that Initiate / Modulate / Coordinate movement.
• The major UMN tract that initiates voluntary movement is the pyramidal tract
• UMN disease is a wide and varied collection of disease which have UMN involvement in common

Entities

Upper motor neuron entities are

• Muscle Weakness / Paralysis
• Incoordination: Decreased motor control including Speed, Accuracy and Dexterity
• Hypotonia or Hypertonia / Spasm
• Decreased endurance
• Hyper reflexia: Exaggerated deep tendon reflexes
• Spasticity
• Clonus
• Reappearance of primitive reflexes, such as the extensor plantar response (Babinski sign)

Causes

Dynamic	Static
Primary lateral sclerosis ALS Motor Neuron Disease	Upper motor neuron lesions

Entity / Miasms

	GSS	CJD	NVCJD	HTLV-1	JE	EEE/ WEE
Hyper Reflexia	+++	+++	+++	+++	+++	+++
Primitive reflexes			+++	+++
Incoordination	+++	+++	+++
Spacticity	+++	+++		+++	+++	+++

Note

• UMN tract is initiating and coordinating movement.
• So I suggest The rubric "Spastic paralysis" for problem in initiating muscular movement
• And also the rubric "Incoordination" for problem in coordination