Hard sign of UMNL include

a)      Hypertonia

b)      Superficial reflex lost

c)       Brisk knee jerk

d)      Babinski’s sign positive

Upper motor neuron lesion Davidson 22 page 1162

 

• Inspection Normal (may be wasting in chronic lesions)


• Tone Increased with clonus


• Pattern of weakness Preferentially affects extensors in arms, flexors in leg Hemiparesis, paraparesis or tetraparesis


• Deep tendon reflexes Increased


• Plantar response Extensor (Babinski sign)

 

So the most probable answer is a) Hypertonia and d) Babinski’s sign positive

Upper Motor Neuron Lesion Davidson 22 page 1145

Lesions  affecting  the  upper  motor  neuron  result  in  increased  tone,  most  evident  in  the  strongest muscle groups (i.e. the extensors of the lower limbs and the flexors of the upper limbs).  The increased tone is more apparent during rapid stretching (‘spastic catch’), but may suddenly give way with sustained tension (the ‘clasp-knife’ phenomenon).

Hypertonia may be is seen in other disorders. They include: Cerebral palsy, Stroke, Spinal cord injury.

Babinski sign: An important neurologic examination based upon what the big toe does when the sole of the foot is stimulated. If the big toe goes up, that may mean trouble.

This reflex is normal in children up to 2 years old. It disappears as the child gets older. It may disappear as early as 12 months.

The Babinski sign is known by a number of other names: the plantar response (because the sole is the plantar surface of the foot), the toe or big toe sign or phenomenon, and the Babinski reflex, response or phenomenon.

How to Elicit Babinski sign Video