Motor and Sensory Deficits

Hemiparesis is weakness down one side of the body of an upper motor neurone nature. The weakness can be graded using the Medical Research Council scale. Hemiplegia refers to complete paresis (MRC grade 0 power).

Hemisensory loss is typically the loss of light touch sensation down one side. This can be confused with sensory neglect if not specifically tested for by presenting first unilateral and the bilateral stimuli.


Normal tone video In this video a doctor is assessing tone, which in this case is normal.
Normal power video Here the doctor is assessing power in the upper limbs, again this is normal.
Normal reflexes video This patient's reflexes are normal in the upper limbs.
Light touch video Here the doctor establishes that light touch is present bilaterally and that the patient is able to identify when both sides are touched simultaneously, therefore there is no sensory neglect. In a patient with sensory neglect, they would be able to identify unilateral stimuli but neglects one side when tested bilaterally.
This is a quick and simple way of assessing upper limb function. When the patient holds their arms out straight, you can see that there is no pyramidal drift. The patient is able to recognise left from right, and their coordination is intact as he is able to touch his nose.
Left upper limb weakness video In this example, the quick screen reveal left sided weakness, with the patient unable to extend the fingers against gravity.
Left hand video weakness Here power is being tested. It is normal on the right hand side, but obviously weak on the left, especially the extensor muscles, typical of pyramidal weakness seen in stroke. The patient is unable to extend his fingers against gravity (grade 3 power on the MRC scale); he is able to extend the wrist against gravity but not against resistance (grade 4 power).