Focal Cerebral Hemispheric Lesion: Likelihood Ratios

Introduction: None written.

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The likelihood ratios of findings for Focal Cerebral Hemispheric Lesion are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Finger-Nose	+ 0 -	1.8	1
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Impaired Repetition	+ 0 -	1.3	1
cognitive defect Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Impaired Balance on One Foot	+ 0 -	0.8	1.1
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] Weakness	+ 0 -	inf	0.7
(unilateral) Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Rapid Alternating Movements	+ 0 -	inf	0.7
aka dysdiadochokinesis Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Finger-Rolling Test	+ 0 -	inf	0.7
In the finger rolling test each index finger was rotated around the other for five seconds in each direction. An abnormal response was present if one finger orbited around the other. Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Forearm-Rolling Test	+ 0 -	inf	0.8
One forearm was rolled about the other. Abnormal test = forearm 'orbits' the other. Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Pronator Drift	+ 0 -	inf	0.8
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Anomia	+ 0 -	inf	0.8
cognitive defect in naming Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Shoulder Shrug	+ 0 -	inf	0.9
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Graphasthesia	+ 0 -	inf	0.9
i.e. reading a number by feel in the palm of the hand Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Thumb Finding	+ 0 -	inf	0.9
tests position sense Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Sensory Extinction	+ 0 -	inf	0.9
bilateral stimulation -> patient aware of only 1 side Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Babinski Reflex	+ 0 -	inf	0.9
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Optokinetic Nystagmus	+ 0 -	inf	0.9
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Hoffman's Sign	+ 0 -	inf	1
"The test involves tapping the nail or flicking the terminal phalanx of the third or fourth finger. A positive response is seen with flexion of the terminal phalanx of the thumb." Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Spasticity	+ 0 -	inf	1
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Light Touch	+ 0 -	inf	1
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Joint Position	+ 0 -	inf	1
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Visual Field Defect	+ 0 -	4.4	0.8
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Two-point Discrimination	+ 0 -	4	0.8
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Facial Weakness	+ 0 -	3.4	0.9
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Impaired Calculation	+ 0 -	3.4	0.9
cognitive deficit Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Impaired Graphical Construction	+ 0 -	2.7	0.8
cognitive test to replicate interlocking pentagons Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Hyperreflexia	+ 0 -	2.2	0.9
Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Wartenberg's Sign	+ 0 -	2.2	0.9
"A sign noting the position of abduction assumed by the little finger. In ulnar paralysis the little finger is in a position of abduction." Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Stereognosis	+ 0 -	2.2	0.9
perceive an object simply by touch Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443
[ + ] Reduction in Arm Swing	+ 0 -	2	0.9
unilateral reduction in arm swing while walking. Note: 4/10 patients had abnormalities ipsilateral to the lesion! Study: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):545-9. PMID: 15774443