From the Guidelines
Neurological deficit symptoms include altered consciousness, confusion, memory problems, speech difficulties, vision changes, hearing loss, smell or taste disturbances, weakness or paralysis, numbness or tingling, coordination problems, balance issues, tremors, seizures, headaches, dizziness, and changes in reflexes. These symptoms occur when there's damage to the brain, spinal cord, or peripheral nerves, disrupting normal neurological function. The specific symptoms depend on which part of the nervous system is affected. For example, damage to the frontal lobe may cause personality changes and difficulty with decision-making, while damage to the cerebellum typically results in coordination problems. Motor pathways damage leads to weakness or paralysis, while sensory pathway disruption causes numbness or abnormal sensations. Cranial nerve involvement produces specific deficits related to their function, such as facial weakness with facial nerve damage. Some common symptoms of neurological deficits include:
- Memory problems, such as repetitive questions or conversations, misplacing personal belongings, forgetting events or appointments, and getting lost on a familiar route, as noted in the study by 1
- Impaired language functions, including difficulty thinking of common words while speaking, hesitations, speech, spelling, and writing errors, as reported in the study by 1
- Sudden onset of focal neurological symptoms, such as weakness or paralysis, numbness or tingling, coordination problems, balance issues, tremors, seizures, headaches, and dizziness, as described in the study by 1 These symptoms may develop suddenly (as in stroke) or gradually (as in degenerative conditions), and their pattern, progression, and associated features help clinicians determine the underlying cause and location of neurological damage. In patients with ischemic stroke, the diagnosis of neurological deficit is critical, and treatment with rtPA should be considered, as outlined in the guidelines by 1 and 1. However, caution should be exercised in treating patients with major deficits, and the decision to treat with rtPA should be made with careful consideration of the potential risks and benefits.
From the Research
Neurological Deficit Symptoms
The symptoms of neurological deficits can vary depending on the underlying cause and location of the damage. Some common symptoms include:
- Damage to the pyramidal, sensory, extrapyramidal, coordinating systems, and cranial nerves 2
- Higher cortical function disorders, such as cephalic, asthenic, and emotional disorders 2
- Focal neurological symptoms, including motor deficits, cognitive disorders, and disorders of the emotional sphere 2, 3
- Progressing neurological deficit, characterized by a decrease in global neurological scale score during hospitalization 3
- Acute focal neurologic deficit, which can be caused by salicylate toxicity 4
- Abrupt onset focal neurological deficits, which can be a symptom of acute ischemic stroke 5
Assessment and Management
The assessment and management of neurological deficits can be challenging, and it is essential to consider various factors, including:
- The use of neuroimaging paradigms, such as non-contrast computed tomography (CT), magnetic resonance imaging (MRI), and vascular and perfusion imaging, to diagnose and treat acute ischemic stroke 5
- The identification of functional neurologic symptoms, which can be inconsistent and incongruent with neurologic disease, and require a careful assessment and management approach 6
- The development of scales, such as the Modified Assessment of Neurological and Neuropsychological Deficits (MANND), to assess the severity of neurological and neuropsychological deficits in patients with chronic cerebral ischemia 2