ABPMR PM&R key terms

Constellation of weakness, loss of fine dexterity, spasticity, hyperreflexia, and extensor plantar responses caused by damage to descending corticospinal and related pathways anywhere above the anterior horn cell.

Hemisection of the spinal cord that produces ipsilateral weakness and loss of vibration and proprioception, with contralateral loss of pain and temperature starting one or two levels below the lesion.

Incomplete cervical spinal cord injury, often from hyperextension of a stenotic canal, in which arm weakness exceeds leg weakness and bladder and sensory deficits vary; walking prognosis is generally favorable.

Acquired loss or impairment of language after brain injury, most often left hemisphere stroke, affecting naming, comprehension, repetition, or fluency; it is distinct from the speech production errors of dysarthria.

Failure to attend to or act on stimuli on the side opposite a brain lesion, usually right parietal, despite intact primary sensation; it impairs safety, grooming, reading, and wheelchair mobility.

After stroke, the patient actively pushes the body toward the hemiparetic side and resists correction to upright, reflecting a disturbed perception of verticality; it needs specific training rather than simple verbal cueing.

Acute immune-mediated polyneuropathy, usually demyelinating, producing ascending symmetric weakness and areflexia with possible autonomic instability and respiratory failure; monitored with vital capacity and treated with IVIG or plasma exchange.

Autoimmune disorder of the neuromuscular junction causing fatigable weakness that worsens with use and improves with rest, often affecting eyelid, bulbar, and proximal limb muscles; treated with cholinesterase inhibitors and immunomodulation.

New weakness, fatigue, and muscle pain appearing decades after paralytic poliomyelitis in previously affected or seemingly spared muscles, attributed to degeneration of enlarged motor units; managed with pacing, strengthening within tolerance, and energy conservation.

Immune-mediated demyelinating disease of the central nervous system with relapses disseminated in time and space; rehabilitation targets fatigue, heat sensitivity, spasticity, bladder dysfunction, and mobility.

Neurodegenerative basal ganglia disorder causing resting tremor, bradykinesia, rigidity, and postural instability; exercise, external cueing, and medication timing improve mobility, and freezing of gait is a common fall risk.

Trauma-induced disturbance of brain function with rapid onset of headache, confusion, dizziness, or imbalance that gradually resolves; management is relative rest followed by graded return to cognitive and physical activity.

Tear of the ligament restraining anterior tibial translation and rotation, common in pivoting sports; rehabilitation emphasizes quadriceps strength, neuromuscular control, and criteria-based return to sport after reconstruction or nonoperative care.

Pain and functional loss from overload of the supraspinatus or other cuff tendons without prominent acute inflammation; treated with activity modification and progressive strengthening of the cuff and scapular stabilizers.

Spectrum from bone marrow edema and periosteal reaction to complete fracture caused by repetitive loading that outpaces repair; high-risk sites such as the femoral neck and anterior tibia require restricted weight bearing.

Exercise-induced rise in pressure within a closed fascial compartment causing aching tightness that resolves with rest; confirmed by intramuscular pressure testing and managed with activity change or fasciotomy.

Degenerative joint disease with cartilage loss, subchondral change, and synovitis causing activity-related pain and stiffness; exercise, weight management, and assistive devices are first-line, with arthroplasty reserved for advanced disease.

Summed response recorded from a muscle after supramaximal stimulation of its motor nerve; amplitude reflects the number of excitable axons and their muscle fibers, while latency reflects conduction speed along the fastest fibers.

Response recorded over a nerve after stimulating it, reflecting large myelinated sensory axons; a preserved SNAP with abnormal motor findings places the lesion proximal to the dorsal root ganglion, as in radiculopathy.

Late motor response produced by antidromic activation of anterior horn cells after nerve stimulation; prolonged latency suggests proximal slowing, and absent F-waves accompany severe axonal loss.

Monosynaptic reflex recorded from the soleus after submaximal tibial nerve stimulation, analogous to the ankle jerk; prolonged latency indicates slowing in the proximal tibial nerve or S1 root.

Spontaneous discharges of individual denervated muscle fibers seen as brief regular spikes on needle EMG; they appear weeks after nerve injury and indicate active axonal loss or an inflammatory myopathy.

Waveform generated by a single motor unit during needle EMG, described by duration, amplitude, and phases; long, large, polyphasic units indicate chronic reinnervation, while short small units suggest myopathy.

Fall in CMAP amplitude when stimulating proximal rather than distal to a nerve lesion, with a preserved distal response; it marks focal demyelination and is a hallmark of compressive and immune neuropathies.

Test delivering repeated supramaximal stimuli at 2 to 3 Hz to detect a decrement in CMAP amplitude, which indicates impaired neuromuscular junction transmission as seen in myasthenia gravis.

Reflex blood pressure surge triggered by a noxious stimulus below a spinal cord lesion at or above T6, with pounding headache, flushing, sweating, and bradycardia; the trigger must be found and removed immediately.

Formation of mature bone in soft tissues, most often around hips and knees after spinal cord injury or traumatic brain injury, causing swelling, warmth, pain, and loss of joint range.

Lower urinary tract dysfunction caused by neurologic disease, described by whether the detrusor is overactive or areflexic and whether sphincter coordination is lost; management aims to protect the kidneys and achieve continence.

Systolic fall of at least 20 mmHg or diastolic fall of at least 10 mmHg on standing, producing dizziness or syncope; common after spinal cord injury and prolonged bed rest, managed with gradual upright positioning, compression, and volume expansion.

Localized damage to skin and underlying tissue over a bony prominence from sustained pressure and shear, staged from non-blanchable erythema to full-thickness loss; prevention uses repositioning, appropriate support surfaces, and moisture control.

Nonprogressive disorder of movement and posture from injury to the developing brain, classified by motor type and body distribution and graded with the Gross Motor Function Classification System to guide prognosis and services.

Neural tube defect in which meninges and spinal cord protrude through a vertebral defect; outcome depends on lesion level, and hydrocephalus, neurogenic bladder, tethered cord, and latex allergy are key concerns.

Birth injury to the upper brachial plexus at C5-C6 producing shoulder adduction, elbow extension, and forearm pronation; most infants recover, and persistent weakness may need therapy or nerve surgery.

X-linked dystrophin deficiency causing progressive proximal weakness from early childhood; corticosteroids, stretching, bracing, and nocturnal ventilation prolong ambulation and survival, while scoliosis and cardiomyopathy require monitoring.

Velocity-dependent increase in resistance to passive muscle stretch caused by hyperexcitable stretch reflexes after upper motor neuron injury; graded with the Modified Ashworth Scale and treated with therapy, oral drugs, chemodenervation, or intrathecal baclofen.

Injection of a neurotoxin that blocks presynaptic acetylcholine release at the neuromuscular junction, producing temporary focal weakness used for spasticity, focal dystonia, and sialorrhea; total dose is limited by systemic spread.

Continuous delivery of a GABA-B agonist into cerebrospinal fluid by an implanted pump to relieve severe spasticity with fewer systemic effects; abrupt interruption can cause withdrawal with rigidity, fever, and altered mental status.

Disproportionate pain with sensory, vasomotor, sudomotor, and trophic changes after injury, diagnosed clinically by the Budapest criteria; treatment combines graded movement, desensitization, and pain modulation.

Pain caused by a lesion or disease of the somatosensory nervous system, often burning or electric with allodynia; first-line drugs include gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors.

External brace that controls ankle motion to clear the toes, prevent equinus deformity, or stabilize stance; design choice among solid, hinged, and posterior leaf-spring types follows the gait problem and tone pattern.