1. How does one localize the lesion based on anatomical diagnosis and other ancillary procedures?

2. Lower Motor Neuron Lesion In the Case: – Patient has the following LMN symptoms: (+) Atrophy of right gastrocnemius muscle and soleus muscles (+) Areflexia in Right ankle jerk (-) Babinski bilaterally

3. Peripheral Nerve Lesion WEAKNESSDistal, symmetrical OBJECTIVE/SENSORY DEFICITSDistal, symmetical AUTONOMIC DISTURBANCESMay be present REFLEXESAreflexia

4. Lumbar Radiculopathy L5-S1 – In the patient: Numbness in the back of the right calf muscle, lateral heel, foot and toe Weakness of the right plantar flexion of foot and toes Difficulty walking on toes on the right Right ankle jerk absent

5. Weakness of the right plantar flexion of foot and toes

6. Numbness in back of the right calf muscle, lateral heel, foot and toe

7. Both knee jerks are (++) Right ankle jerk absent, left ankle jerk (++) Numbness in lateral heel, foot and toe

8. Diagnosis If no improvement in symptoms have occurred in six weeks or red flags are present, imaging is appropriate. These include either CT or MRI. CT scan  used to evaluate the bony anatomy in the lumbar spine, which can show how much space is available for the nerve roots. The nerve roots exit the spinal canal through a bony tunnel called the neuroforamen, and it is at this point that the nerve roots are especially vulnerable to compression. MRI scan  useful for determining where the nerve roots are being compressed ; shows the details of soft-tissue structures, like nerves and discs.

9. Diagnosis Imaging methods such as MR neurography may help in diagnosis and treatment of sciatica/lumbar radiculopathy. MR neurography has been shown to diagnose 95% of severe sciatica patients. MR neurography is a modified MRI technique using MRI software to provide better pictures of the spinal nerves and the effect of compression on these nerves.