• hemiparesis - weakness down one side
• hemiplegia - paralysis down one side

Both indicate damage including the contralateral motor strip

• hemianasthesia - loss of sensation down one side

Indicates damage to the contra-lateral sensory strip

3. Visual problems

• hemianopia - loss of half the visual field (centred around the midline)
• quandrantanopia - loss of one quarter of the visual field

Both indicate damage to primary visual cortex, contra-lateral to the field loss.

Neglect - an inattention to one side of space. This can include vision, audition, sensation. E.g. patients will ignore you if you stand on their 'neglected side', or speak to them from that side. They might only eat the food from one half of their plate and ignore the rest. People will bisect a horizontal line well away from the middle. This generally indicates damage to the contra-lateral parietal cortex. Left neglect (after right parietal damage) is much more common than right neglect, although both are seen immediately after injury, left neglect seems to persist for longer.

Extinction - this is commonly seen once neglect has remediated, and is also a sign of parietal damage. Here patients will not report events that occur on the contra-lateral side of space, if a simultaneous event occurs on the ispsi-lateral (same side as the lesion). Thus someone with left extinction will report 'finger wags' if one finger is wiggled on the right, or one on the left side of space; if however both fingers are wiggled together, the patient only reports the right finger moving - it literally extinguishes the event on the left.

5. Reflexes - a loss or a change to these can reflect local damage.

e.g. Pupil responses - if the pupil does not contract when exposed to light, it suggests damage to the nerve either in the brain stem nuclei or in the peripheral nerve itself.

Babinski reflex - if you tickle the feet of a new born child the toes splay out - this is the Babinski reflex. If you tickle the feet of an adult, the foot curls. If the adult shows the Babinski reflex, this suggests damage to the cortical control of motor responses, e.g. the motor strip.

6. Apraxias

These are disorders of learned movements

Most common. Cannot carry out an action to command, but can do the same act spontaneously, e.g. smile. Can be limited to one part of the body. Can affect testing of comprehension. Patients can do better if they can imitate or use an object.

Patients cannot plan a sequence of movements, e.g. light a candle. This can cause great problems in everyday life. They can typically imitate. Indicates bilateral damage.

This affects fine motor movements, e.g. doing up buttons. It affects both automatic and voluntary movements. Indicates premotor lesions.

Demonstrate problems with spatial construction, cannot copy figures or block arrangements. Indicates parietal lobe lesions, and can affect test performance.

The patient cannot dress themselves, as they have problems relating their clothing to their body. Indicates right parietal lesions.

Cannot control voluntary muscle movements when speaking. Reflects problems in the motor programming of speech, and leads to articulatory problems, and disordered prosody (pausing, slow speech, altered stress). Patients appear to visibly grope for the right position of the mouth. They can make a wide variety of errors. Unlike dysarthrics, they are thought to make substitutions of phonemes, rather than distortions, though this claim is controversial. They have more problems with repetition than in spontaneous speech, and their automatic and reactive speech can be OK. Co-occurs with aphasia.

7. Alexia - reading problems, indicates damage to primary visual cortex and lateral occipital regions

8. Agraphia - writing problems, often follows damage to the left angular gyrus.

9. Agnosia - a disorder of object recognition

• Visual - extensive, bilateral temporal-parietal damage.
• Auditory - very rare without aphasia - indicates mid superior temporal sulcus damage, bilaterally.
• Tactile - bilateral parietal damage.
• Autopagnosia - don't recognise part of body as own body - posterior inferior parietal lobe damage
• Anosagnosia - lack of recognition of own deficits - damage to supramarginal gyrus.