ABSTRACT
The pattern of weakness or numbness, together with any associated symptoms and signs, will allow clinical localisation of the lesion. The production of smooth coordinated movements is dependent both on adequate functioning of the cerebellum and on sensory feedback from the joints, muscles and skin. Patients with acute neuromuscular weakness are at risk of ventilatory failure that may rapidly progress to respiratory arrest. The extrapyramidal system consists of a number of brain areas such as the nigrostriatal pathway and the basal ganglia that are also involved in the regulation of movement. Thrombolysis may improve the functional outcome in selected patients with ischaemic stroke if given within three hours of the onset of symptoms and having definitively excluded haemorrhage. Acute neurological deficit in a patient taking anticoagulants mandates urgent brain imaging to diagnose or rule out intracranial haemorrhage.
