[Cervical Lesions or Peripheral Nerve Disorders? How Far Can Neurological Examination Localize the Lesion?]

Accurate lesion localization is a fundamental component of neurological diagnosis. This review describes how neurological examination can be used to differentiate cervical spinal cord lesions, cervical radiculopathy, brachial plexopathy, and peripheral nerve disorders in patients presenting with upper-limb sensory and motor symptoms. Particular attention is given to the distribution of sensory impairment, tendon reflex abnormalities, and patterns of muscle weakness. The characteristic clinical features of cervical spondylotic myelopathy, cervical radiculopathy, brachial plexus disorders, and entrapment neuropathies are summarized, together with practical considerations for anatomical localization. Common clinical scenarios, including wrist drop, finger drop, dorsal interosseous muscle atrophy, and radial or ulnar-sided hand numbness, are discussed to illustrate the diagnostic approach. Neurological examination remains essential for lesion localization and should be integrated with electrophysiological and imaging studies to achieve an accurate diagnosis.